| Objective: Gastric cancer is one of the most common malignant tumor of digestive system, the mortality rate of gastric cancer among the world is second malignant tumor, which is a serious threat to human life and health. The tumorigenesis of gastric cancer, it is a complex process, is influenced by multitargets, multi-stage, multiple genes, etc. involving proto oncogene, tumor supressor, tumor-related proliferational genes, cancer genes related to apoptosis and metastasis, etc, but definite molecular mechanism of gastric cancer is not entirely clear. Because of later staging, poor prognosis and low survival rate, The new and representative of the significance of the markers should be found in order to prognosis gastric cancer in early stage. Pokemon gene which is a member of the Pok family transcription factor was discovered in 2005, it is a role as "master switch" of the genesis and progress of the tumor. because it is considered as the special of the proto oncogene, it can not only participate in the process of cell cycle and apoptosis, but also the activity of other oncogenes or anti oncogene was regulated. It has been confirmed that the over expression of Pokemon in many tumors, such as breast cancer, bladder cancer, prostate cancer, colorectal cancer, and it is closely related to the tumorigenesis and development of tumor. Cell over proliferation and cell abnormal apoptosis in the development of gastric cancer were considered to be the biological basis of the development of gastric cancern in some study. PCNA and Bcl-2 apoptosis protein family have been proved to be closely related to the tumorigenesis and development of gastric cancer. In this experiment base on gastric cancer patients as the object, detecting the expression of Pokemon, PCNA and bcl-2 in gastric cancer tissues and adjacent normal tissues in order to analysis the relationship of all three from the clinicopathological characteristics and determine their impact of the prognosis of gastric cancer, and then looking for related genes about effecting the treatment and prognosis evaluation of gastric cancer.Methods: Collecting the cases at the Hebei Medical University fourth hospital for surgical treatment of gastric cancer from January 2009 to December 2010, all these samples are examined without chemotherapy treatment before surgery, 130 patients were diagnosed as gastric cancer with complete clinical data and the results of the patients with gastric cancer tissue and normal tissue( 5cm away from the edge of cancer), immunohistochemistry methods Pokemon, PCNA and Bcl-2 were used to detected the protein expression in the three patients with gastric cancer and analysis of sex, age,tumor size, tumor location, degree of differentiation, tumor TNM stages, depth of invasion, lymph node metastasis, nerve or blood vessel invaded, Borrmann type of gastric cancer in clinical histopathologic character records.The pathological characteristics, and analysis of all the three on the prognosis of patients with gastric cancer. All statistical analyses were analyzed by using SPSS 17.0 statistical software, P < 0.05 were considered significant.Result:1 The positive expression of Pokemon in gastric cancer tissue was significantly higher than that in gastric mucosa adjacent to carcinoma, the two were statistically significant(P=0.000, <0.05). The exression of Pokemon in gastric cancer patients is not correlated to sex, age, tumor location, tumor size, histological differentiation, invasion of vascular nerves, Borrmann type(P=0.095, 0.492, 0.146, 0.123, 0.945), and it is correlated to clinicopathological staging, tumor invasion depth, lymph node metastasis(P = 0.024, 0.016, 0.001).2 Prognostic analysis showed that the prognosis of patients with positive expression of Pokemon was significantly lower than that of negative expression patients(P=0.003). We reached the following conclusions that the positive expression of Pokemon in gastric cancer tissue and clinical pathological stage were the independent risk factor for the prognosis of patients with gastric cancer. The expression of Pokemon was analyzed by Cox' s proportional hazards regression analysis.The risk of death in the patients with positive expression of Pokemon was 5.203 times than patients with negative expression of Pokemon(P=0.023) and tumor clinical pathological in stage III and IV patients was 3.411 times than tumor clinical pathological stage I- II patients(P<0.001).3 The positive expression of PCNA in gastric cancer tissue was significantly higher than that in gastric mucosa adjacent to carcinoma, the two were statistically significant(P<0.001). The expression of PCNA in gastric cancer was correlated with the degree of tumor differentiation, clinical pathological stage and lymph node metastasis(P=0.025,0.014,0.001). But with the patient's sex, age, tumor location, tumor size, nerve vascular invasion, Borrmann general classification were not significant correlation(P=0.172,0.168,0.885,0.629, 0.392,0.365). PCNA had a certain effect on the prognosis of patients with gastric cancer, the five-year survival rate of Log-Rank was P=0.022.4 The positive expression of Bcl-2 in gastric cancer tissue was significantly higher than that in gastric mucosa adjacent to carcinoma, the two were statistically significant(P<0.05). Bcl-2 in gastric cancer patients with high expression of sex, age, tumor location, histological differentiation, there is no nerve vascular invasion, Borrmann type had no significant correlation P=0.746,0.753,0.695,0.127,0.860,0.493, and tumor size, infiltration depth, tumor tumor TNM stages, lymph node metastasis(P=0.024,0.000,0.019,0.000). There was no obvious correlation with Bcl-2 expression and the prognosis of gastric cancer, the five-year survival rate of Log-Rank was P=0.660.5 The relationship of Pokemon, PCNA and Bcl-2 were analyzed by Sperman, the results show that the expression of Pokemon is positively correlated to expression of PCNA(rs = 0.627, P<0.05), there is also a positive correlation between expression of Pokemon with positive expression of Bcl-2(rs =0.310, P<0.05), and the expression of PCNA and Bcl-2 has the same tendency(rs = 0.370, P<0.05).Conclusion:1 The expression of Pokemon were downregulated in primary gastric tumours compared with adjacent normal tissues. It was positively correlated to tumor tumor TNM stages, depth of tumor invasion and lymph node metastasis and had no significant correlation with patient's sex, age, tumor location, tumor size, degree, invasion of vascular nerves and Borrmann type. It indicates that high expression of Pokemon may be involved in the tumorigenesis and development of gastric cancer and related to the metastasis and invasion of gastric cancer, which can provide evidence for early diagnosis, targeted therapy and metastasis of gastric cancer.2 The expression of Pokemon was significantly correlated with the prognosis of gastric cancer patients, the positive expression of Pokemon patients has a poor prognosis. It showed that Pokemon could be used as an independent risk factor affecting the prognosis of patients with gastric cancer and can be used as an indicator to assess the prognosis of patients with gastric cancer.3 The expression of PCNA in gastric cancer was significantly higher than that in adjacent normal tissues. The expression of gastric cancer was negatively correlated with the degree of differentiation of tumor tissues, and there was a positive correlation between clinical pathological stage and lymph node metastasis. But it had no significant correlation with the patient's sex, age, tumor location, tumor size, invasion of nerve vascular invasion and Borrmann type. The over expression of PCNA is closely related to the occurrence, development and metastasis of gastric cancer, and it reflects the proliferation state of the tumor. PCNA have a certain significance for evaluating the prognosis of patients with gastric cancer.4 The expression of Bcl-2 in gastric cancer was significantly higher than that in adjacent normal tissues, and the expression level of Bcl-2 were positively correlated with tumor size, invasion depth, clinical pathological stage and lymph node metastasis. It is illustrated that Bcl-2 is closely related to the growth, invasion and malignancy of gastric cancer, and plays an important role in lymph node metastasis of gastric cancer. The expression of Bcl-2 have no significant correlation with the prognosis of gastric cancer patients by prognosis analysis.5 There were positive correlation with Pokemon, PCNA and Bcl-2 in gastric cancer, and there was a positive correlation between PCNA and Bcl-2. Pokemon as tumor "master switch" may upregulate the expression of PCNA and Bcl-2 expression in gastric cancer, promoting cell proliferation and inhibit cell apoptosis and make cells more susceptible,that plays a role in the occurrence and development of gastric cancer. |
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