CXCL1促进胃癌淋巴道转移的实验研究

摘要

Objective This study was aimed to study the relation of expression of CXCL1 in promoting lymph node metastasis in gastric cancer patients. Methods One hundred patients who underwent gastric radical resection with lymph node dissection in the First Affiliated Hospital of Sun Yat-sen University included continuously. Specimens of these patients were studied. We determined the expression of CXCL1 and LMVD by IHC and studied their relationship with clinicalpathology feature and prognosis. Results CXCL1 protein expression was present in cancerous tissues , CXCL1 protein expression was detected by IHC in 41 patients (41%),which was correlated with advanced TNM stage、LMVD 、tumor differentiation、lymph node metastasis and poor survival. And LMVD was correlated with advanced TNM stage、 size of tumor、lymph node metastasis、tumor differentiation and poor survival. The 5 year survival rate in CXCL1 positive group was less than the CXCL1 negative group (P=0.001). In the Cox regression analysis, we found TNM stage,tumor differentiation,CXCL1 and LMVD as independent prognosis factor. Conclusions The positive expression of CXCL1 is closely related with the invasion and metastasis of advanced gastric cancer. CXCL1 is the independent prognosis factor of gastric cancer.%目的：研究探讨胃癌CXCL1的表达、癌周微淋巴管密度（LMVD）与胃癌患者临床病理学资料的关系，以期证实CXCL1可以促进胃癌的淋巴道转移。方法分析100例接受胃癌根治术患者的临床病理学资料，对其临床病理切片采用免疫组织化学染色法检测CXCL1蛋白的表达，利用D2－40抗体标记癌周淋巴管内皮细胞，计算癌周的淋巴管密度，分析CXCL1及癌周LMVD与患者临床病理特征的关系，尤其是与淋巴结转移和淋巴管侵犯的相关性，并分析其与胃癌预后的关系。结果免疫组化结果显示CXCL1主要存在于细胞胞浆中。 CXCL1阳性比例为41％，与肿瘤分化程度、浸润深度、淋巴结转移和TNM分期相关（均P＜0．05）。 CXCL1表达阳性组有着明显较高的TNM分期和较差的分化程度。胃癌癌周淋巴管密度与胃癌病灶大小、分化程度、临床TNM分期、浸润深度、淋巴结转移有显著相关性（均P＜0．05）。CXCL1阳性组（n＝41）比阴性组（n＝59）的5年生存率要低（P＝0．001），阴性组总体生存时间是40个月，阳性组总体生存时间是23．2个月。经过单变量和多变量筛选后，能够作为独立预后因素的因子为：CXCL1、肿瘤分化程度、TNM分期以及LMVD。结论 CXCL1表达与胃癌的浸袭转移密切相关，是影响胃癌患者预后的独立危险因素。