The Expression And Its Clinical Significance Of Secretory Phospholipase A2 Group ⅡA In Gastric Cancer And Precancerous Lesions

Objective: To investigate the expression of secretory phospholipase A2 groupâ…¡A (â…¡A sPLA2)in gastric carcinama and non-carcinoma, and to study its correlation with helicobacter pylori (Hp) infection,microvessel formation and clinic pathologic characteristics as well as its effect on prognosis of patients with gastric carcinoma.Methods: One hundred pathologic specimens from the patients with advanced gasrtic cancer(AGC) who were received surgical operation in the first affiliated hospital of fujian provincial university from January 2004 to January 2005, were collected as the case group. And the other ninety pathologic specimens, including thirty specimens of normal gastric mucosa(NGM), thirty specimens of chronic gastritis with intestinal metaplasia(IM) and thirty specimens of dysplasia(DYS), were also collected as the control groups. All of the pathologic specimens were detected the expression ofâ…¡A sPLA2 protein, infection of Hp by immunohistochemistry with MaxVision method. And microvessel density labeled with CD34 of AGC was also detected by the same method. The prognosis of patients with AGC were analyzed with Kaplan-Meier curve.And moreover the risk factors influencing the patients'prognosis were evaluated with analysis of Cox regression.Results : The positive expression ofâ…¡A sPLA2 in IM group(88.3%), DYS group(66.7%) and AGC group(44.0%) were higher significantly, compared with the corresponding value in NGM group(23.3%) (P<0.05). And moreover, the positive expression ofâ…¡A sPLA2 in AGC group was lower significantly than in IM and DYS groups(P<0.05). There was not significant difference of the rate of Hp infection among the groups of IM(43.3%), DYS(36.7%) and AGC(38.0%) (P>0.05), but the Hp infection rate of them was higher than that of NGM group(P<0.05). In the IM and DYS groups, the expression ofâ…¡A sPLA2 in the specimens with Hp infection was higher evidently than that without Hp infection (P<0.05). But in the AGC group, there was not difference of theâ…¡A sPLA2 expression between the specimens with Hp infection and without Hp infection(P>0.05). In AGC group, the microvessel density of the specimens with higherâ…¡A sPLA2 expreesion levels was less than that with lower expression levels (P<0.05). The positive expression ofâ…¡A sPLA2 decreased remarkably in AGC with pelvic lymph node metastasis or chorion invasion(P<0.05). Otherwise, the expression ofâ…¡A sPLA2 in AGC was not correlated with age, gender, tumor location or histological grading(P>0.05). And moreover, the patients with higher levels ofâ…¡A sPLA2 expression had significantly extended survival(P<0.05). Cox model analysis showed that chorion invasion, gender and lowerâ…¡A sPLA2 expreesion were the independent prognostic factors for the patients with AGC.Conclusion: The loss expression ofâ…¡A sPLA2 may be an early event during the pathogenesis of the gastric cancer and was not correlated with Hp infection. The expression level ofâ…¡A sPLA2 was relevant with the formation of microvessels in the mesemchymal of gastric cancer, and the drop of theâ…¡A sPLA2 expression may be enhance the microvessel formation of the gastric tumor. The loss expression ofâ…¡A sPLA2 may participate in the invasion and metastasis of gastric cancer. Theâ…¡A sPLA2 expression level was related with the survival of the patients with gastric cancer, it would disirable to become an ideal marker to evaluate the prognosis of patients.