【作者】 高雅玲；

【导师】 任建林；

【作者基本信息】 福建医科大学 ， 内科学， 2010， 硕士

【摘要】 目的检测再生基因4 (regenerating islet-derived family member 4,RegIV)在各种胃癌(gastric carcinoma,GC)及胃非癌组织中的表达情况,并探讨其可能临床意义。方法运用免疫组织化学方法半定量检测73例我院胃癌手术切除标本和90例胃癌、癌旁非癌组织芯片中RegIV蛋白的表达情况。结果RegIV选择性表达于胃黏膜的壁细胞中,胃小凹上皮细胞为RegIV阴性。RegIV在胃黏膜肠化生杯状细胞呈固定强胞浆染色(阳性率100%)。肠型胃癌(杯状细胞可见)、胃印戒细胞癌、粘液腺癌的癌细胞中呈RegIV的频繁免疫反应性(分别为100%(3/3)、93.3%(14/15)和90.9%(10/11))。RegIV强核周染色在肠化生基础上的神经内分泌细胞中见到,6例胃神经内分泌癌无1例见RegIV表达。RegIV的表达与胃癌的侵袭参数(包括浸润深度、转移或TNM分期)无明显相关性(P>0.05),RegIV的表达与胃癌的组织分型相关(P<0.05),其在肠型和弥漫浸润型胃癌中的表达差异有统计学意义。组织芯片免疫组化染色形态同我院石蜡组织切片。但30例胃管状腺癌无1例出现RegIV阳性表达(阳性率0%)。RegIV在胃粘液腺癌和印戒细胞癌中的表达阳性率分别为43.3%(13/30)和40.0%(12/30),与我院组织标本的阳性率有较大差异。结论RegIV在胃黏膜肠化生杯状细胞、胃印戒细胞癌、粘液腺癌中显示频繁免疫反应性,RegIV可能参与从肠上皮化生、杯状异型增生发展成胃腺癌的癌变过程。RegIV的表达是否与胃癌的神经内分泌分化有关需进一步证实。RegIV的表达与胃癌患者的临床病理学特征无明显相关,但不能完全排除其可能参与肿瘤细胞的侵袭浸润行为。我院石蜡包埋胃癌手术标本与组织芯片的免疫组化结果并未显示严格一致性,考虑与地域差异等因素有关。更多还原

【Abstract】 OBJECTIVE To investigate the expression and significance of RegIV( regenerating islet-derived family member 4) protein in gastric neoplastic and nonneoplastic tissues.METHOD RegIV protein was detected with immunohistochemiscal (IHC) methods in 73 GC specimens that were collected from surgical resection in our hospital and a tissue microarray(TMA) of 90 GC specimens with adjacent non-neoplastic mucosa.RESULTS RegIV was selectively expressed in the parietal cells of gastric mucosa, and was absent in foveolar epithelial cells. In intestinal metaplasia (IM) of the stomach, goblet cells were strongly positive for RegIV (positive rate 100%). Intestinal gastric carcinomas (with goblet cells present), gastric signet ring cell carcinomas (SRCCs) and mucinous adenocarcinomas showed frequently immunoreactivity (100%(3/3)、93.3%(14/15)and 90.9%(10/11)respectively). Neuroendocrine cells at the base of intestinal metaplasia were strongly perinuclear positive for Reg IV, none of the 6 cases of gastric neuroendocrine neoplasm showed RegIV staining. No association of Reg IV expression with aggressive parameters of gastric carcinoma, including invasion, metastasis, or TNM staging was found ( P>0.05 ) .However, RegIV expression was associated with histopathological subtype(sP<0.05). The expressive difference of RegIV in intestinal and diffusetype gastric carcinoma was of statistical significance. The staining pattern of tissue microarray of the stomach was similar to that of paraffin tissue sections collected from our hospital. None of 30 cases of gastric tubular adenocarcinoma was positive for RegIV(positive rate 0%).The positive rate of RegIV expression in gastric mucinous adenocarcinomas and SRCCs were 43.3%(13/30)and 40.0%(12/30)respectively, which were apparently different from that of specimens supported by our hospital.CONCLUSION Goblet cells of intestinal metaplasia of the stomach,gastric SRCCs and mucinous adenocarcinomas expressed Reg IV more frequently than other histologic subtypes, indicating that Reg IV might be involved in the molecular mechanisms of gastric carcinogenesis from IM and globoid dysplasia to adenocarcinoma. Whether Reg IV expression is associated with the neuroendocrine differentiation in gastric carcinoma needs to be confirmed. No association of Reg IV expression with clinicopathological features of patients with gastric cancer was found, however, the potential role of RegIV in invasive behavior of malignant cells could not be excluded completely. The inconsistent IHC results detected in 2 sources of tissues were considered to be associated with many factors such as arealvariation.更多还原