| Background:Gastric carcinoma, is one of the most common digestive malignant tumors in our country, whose morbidity and mortality takes the first place. The genesis of gastric carcinoma is a complicated process with multifactor control, multistage, multistep, multiple genes mutation formation, its mechanism of molecular biology is very complicated. The classical theory of the origin of tumor cells considered that the tumor originated from normal cells, normal cells mutate into cancer cells which have unlimited ability to replicate and was relatively endless growth, therefore, the study of tumor genesis and development mechanism is focused on cloning and functional analysis of tumor-related gene, cell signaling, control of cell cycle, and so on. Recently, Proposed that tumor derived from stem cells, and stem cell theory is used to cancer research, confirmed that some cancer cells have the capacity of self-renewal and differentiation, and thus proposed the "cancer stem cell" concept, cancer stem cell theory has exploited new views for cancer research. Now, considered that cancer stem cells play important roles in genesis, development, metastasis and prognosis of tumor, cancer stem cell associated markers were used to analyze prognosis of patients with tumor, which has some theories and views of clinical application. In the previous experimental study, we found omental milky spots metastatic tumor cells with cancer stem cell characteristics, with high expression of CD 133, and the expression of CD324 was decreased or negative, the CD133+and CD324- may be one of surface markers of gastric cancer stem cells.Objective:To detect the expression of gastric cancer associated markers CD133 and CD324 in gastric cancer, analysis of its relationship with clinicopathological parameters of gastric cancer, in order to reveal the role and significance of invasion and metastasis of gastric carcinoma. Analyse the relationships between the expression of CD133 and CD324 in gastric cancer, to explore the relationships between the expression of associated markers CD133, CD324 and prognosis of patient with gastric cancer.Method:A total of 100 patients with primary gastric cancer were enrolled in this study. All patients underwent curative (RO) gastric resection with lymphadenectomy at The First Affiliated Hospital of Dalian Medical University between January 2000 and January 2002. None of the patients received radiationtherapy or chemotherapy before operation. The clinical data on gender, age, location of tumors and extent of lymph node dissection were obtained from medical records and the data on depth of tumor invasion, tumor size, histologic differentiation, lymphovascular invasion were obtained from pathologic reports. In this study, all cases were successfully followed up,10 cases of normal gastric tissues were selected as control group. SP immunohistochemistry staining was used to observe the expression of CD133 and CD324 in gastric tissues. SPSS13.0 was used to analyze the data obtained in the experiment.Result:1. CD133 showed negative or only a few cells expression on the cell membrane surface in normal gastric tissues, was positive expressed mainly on the cell membrane surface in gastric cancer, some with cytoplasmic expression. The expression of CD133 have significant difference between gastric cancer and normal tissues(P<0.05), was not associated with the gender, age, tumor location, tumor size of patients in gastric cancer(P<0.05). The positive expression of CD 133 was increased gradually with the depth of tumor invasion (P<0.05). There was higher positive expression of CD133 with the histological grade from well to poor(P<0.05). The positive expression of CD133 was markedly higher in cancer with the increase in the number of lymph node metastasis (P<0.05). The expression of CD133 was increased gradually, corresponding to TNM stage fromâ… toâ…£(P<0.01). The Log-rank univariate analysis test of the effect of CD133 expression on postoperative gastric cancer survival rates(P<0.01), multivariate Cox regression analysis (B=-0.787,P<0.05), CD133 was independent prognostic factor for postoperative gastric cancer survival time. Regression coefficient was negative, there was negatively correlated between the expression of CD133 and postoperative survival time of patients with gastric cancer.2. CD324 showed strong positive expressed mainly on the cell membrane surface in normal gastric tissues, some with cytoplasmic expression, was negative or only a few cells expression on the cell membrane surface in gastric cancer. The expression of CD324 have significant difference between gastric cancer and normal tissues(P<0.05), was not associated with the gender, age, tumor location, tumor size of patients in gastric cancer(P<0.05).The positive expression of CD324 was decreased gradually with the depth of tumor invasion (P<0.01). There was higher negative expression of CD324 with the histological grade from well to poor(P<0.05). The negative expression of CD324 was markedly higher in cancer with the increase in the number of lymph node metastasis (P<0.01). The negative expression of CD324 was increased gradually, corresponding to TNM stage from I to IV(P<0.01). The Log-rank univariate analysis test of the effect of CD324 expression on postoperative gastric cancer survival rates(P<0.01), multivariate Cox regression analysis(B=1.089,P=0.002), CD324 was independent prognostic factor for postoperative gastric cancer survival time. Regression coefficient was positive, there was positively correlated between the expression of CD324 and postoperative survival time of patients with gastric cancer.3. The expressions of CD133, CD324 in gastric cancer were negatively correlated (r=-0.221,P<0.05). The patients of CD133+CD324-co-expression have worse prognosis.Conclusion:1. CD133 and CD324 play a role in generation, evolution, metastasis and prognosis of gastric carcinoma and can be used as useful indicators for clinical assessment of tumor biological behavior and prognosis in patients with gastric carcinoma.2. The expressions of CD133, CD324 in gastric cancer were negatively correlated, The patients of CD133+CD324-co-expression have worse prognosis,CD133+CD324-co-expression play a role in evaluating the prognosis. |
PDF Full Text Request