| BACKGROUND AND OBJECTIVE:Gastric carcinoma is a common gastrointestinal carcinoma in our country,which threatens the human health seriously,and its mobility and mortality ranks the second in all kinds of the malignant tumor.The treatment principle is the surgery primarily,but usually it metabasis before dignosis,therefore most has lost the surgery opportunity,and chose the chemotherapy based complex therapy.Gastric signet ring cell carcinoma is a special pathological type of the gastric carcinma,which is one of the malignant tumors occurring in youth highly,and holds certain proportion in the primary gastric carcinoma.Gastric signet ring cell carcinoma have no special clinical manifestation.It's easy to misdiagnose,and often occupying advanced stage and having metastasis when dignosis.It's insensitive to the chemotherapy,and the prognosis misses extremely,its natural course is only 3～6 months.Gastric signet ring cell carcinoma is a kind of malignant tumor with low difference,strong invasiveness,ability to grow in the stomach wall easily,quick progress speed,high transferability,difficulty to diagnosis and a bad prognosis,thus, its special clinical character,the biological character and behavior,the treatment and prognosis,and so on,revokes our attention.5-Fu,AMD,DDP,L-OHP,CPT-11,VP-16 and so on is commonly used in the chemotherapy treatment of gastric carcinoma,in which the 5-Fu/platinum union chemotherapy are most commonly used.However the primary or acquired tumor insensitive to gastric carcinoma often affect the chemotherapy effect frequently,and is one of the most common and difficult clinical problems in antineoplastic therapy.The excision repair complementary gene(ERCC1),thymidylate synzyme(TS),the Glutathione-S-transferases(GST-π)is loosely correlating with gastric carcinoma treatment and the prognosis.The high expression of ERCC1 with L-OHP,DDP based chemotherapy curative effect is inverse correlation,but to patients without chemotherapy,the ERCC1 high expression is beneficial in the lifetime target.The relationship between ERCC1 and the lifetime still has dispute;The expression of TS in gastric carcinoma and the resistance to 5-FU still has dispute,the majority research thought the TS expression and 5-FU resistance is correlated,and inverse correlation with the lifetime.TS is a bad prognosis target,but also had research which thinks primary expression of TS can not forecast the later curative effect to gastric carcinoma with 5-Fu based chemotherapy;Some researchs indicate that GST-πcan be a predictor for early gastric carcinoma.High expression of GST-πin gastric carcinoma patient is insensitive not only to platinum,but to ADM,5-Fu,MMC,CBP,indicated GSTs-πplay an important role in the multidrug resistance to tumors.This article plans to observe the expression of ERCC1,TS,GST-πin gastric signet ring cell carcinoma and adencarcinoma,to analyze the expression of ERCC1,TS,GST-πin gastric signet ring cell carcinoma and adencarcinoma and its clinical significance,which will benefit us to make good choice in the chemotherapy of gastric signet ring cell carcinoma and adencarcinoma.METHODS:Using immunohistochemistry staining method(the S-P law), with special ERCC1,TS,GST-πmonoclonal antibodies,examines the expression of ERCC1,TS and GST-πin 61 gastric signet ring cell carcinoma and 60 adencarcinoma.Statistical analysis was done by SPSS 13.0 and P＜0.05 was considered significant.Analyzing the expression difference in gastric signet ring cell carcinoma and adencarcinoma,and observe their relation to clinical pathology character,the treatment sensitivity and the prognosis in gastric signet ring cell carcinoma and adencarcinoma. RESULTS:In tumor cells,ERCC1 locates in the cell nucleus,TS locates in the cytoplasma/nucleus,take the expression in the cytoplasma as the positive,GST-πmainly locates in the cytoplasma,the partial cell nuclei also have the expression,take the expression in the cytoplasma as the positive.In 61 gastric signet ring cell carcinoma,the positive expression rate of ERCC1,TS and GST-πis 25.59%(15/61),19.67%(12/61)and 54.10%(33/61).In 60 adencarcinoma,the positive expression rate of ERCC1,TS and GST-πis 26.17%(16/60),38.33%(23/60)and 71.67%(43/60).Between gastric signet ring cell carcinoma and adencarcinoma,the ERCC1 positive expression rate difference has non-significance significance(P＞0.05),while the TS and GST-πpositive expression rate difference has the significance significance(P＜0.05).In gastric signet ring cell carcinoma,difference between the expression of ERCC1,TS,GST-πand patient's sex, the age,drink wine,the pathologic stages,the number of lymph node metastasis has non-significance(P＞0.05),the difference between expression of ERCC1,GST-πand the depth of invasion has statistics significance(P＜0.05).In adenocarcinoma, difference between the expression of ERCC1,TS,GST-πand patient's sex,the age, drink wine,the pathologic stages,the number of lymph node metastasis and the depth of invasion has non-significance(P＞0.05),difference between TS expression and differentiation degree has statistics significance(P＜0.05).In deep invasion(T3-T4) patients,the expression difference of TS,GST-πbetween gastric signet ring cell carcinoma and adencarcinoma has the significance(P＜0.05).CONCLUSIONS:1.The expression of ERCC1 in gastric signet ring cell carcinoma and adencarcinoma has no obvious difference,The expression of TS and GST-πin gastric signet ring cell carcinoma is lower than adencarcinoma obviously.2.The expression of ERCC1,TS,GST-πhas no correlation with patient's sex,the age,drinks wine,the pathology,the number of lymph node metastasis.3.The expression of ERCC1 and GST-πin gastric signet ring cell carcinoma has correlation with the depth of invasion,the deeper it infiltrates,the lower the expression is.There is no correlation between the expression of ERCC1,TS, GST-πwith the adencarcinoma.4.In the deep invasion(T3-T4)patients,the expression of TS and GST-πin gastric signet ring cell carcinoma is lower than adencarcinoma.
|
PDF Full Text Request