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目的探讨较准确地预测胃癌有无淋巴结转移的标志。方法应用逆转录聚合酶链反应(RT-PCR)方法检测43例胃癌组织中的乙酰肝素酶mRNA表达,应用链霉菌抗生物素蛋白-过氧化物酶连接法(SP法)检测胃癌组织中CD44v6、基质金属蛋白(MMP)-7、nm23和syndecan-1蛋白表达情况,并结合可能影响胃癌淋巴结转移的临床病理指标,寻找影响胃癌淋巴结转移的客观指标。结果43例胃癌患者中27例(62.8%)有淋巴结转移,淋巴结转移度是(36.3±30.8)%,中位数是19.0%。胃癌淋巴结转移潜在危险因素的单因素分析显示,肿瘤大小、有无浆膜浸润、乙酰肝素酶表达、CD44v6表达、nm23表达和syndecan-1表达是胃癌淋巴结转移的危险因素。二值多元Logistic回归分析显示,nm23、syndecan-1和有无浆膜浸润是预测胃癌淋巴结转移的独立预后因素,其优势比分别为0.168、0.126和22.546。结论有浆膜浸润的胃癌和nm23、syndecan-1蛋白阳性表达者发生淋巴结转移的可能性较大。
Objective To explore the more accurate prediction of gastric cancer with or without lymph node metastasis markers. Methods The expression of heparanase mRNA in 43 cases of gastric cancer tissues was detected by RT-PCR. The expression of heparanase mRNA in gastric cancer tissues was detected by streptavidin-peroxidase (SP method) CD44v6, MMP-7, nm23 and syndecan-1 protein in gastric cancer and to find out the objective indexes that affect the lymph node metastasis of gastric cancer in combination with the clinicopathological parameters that may affect the lymph node metastasis of gastric cancer. Results Twenty-seven patients (62.8%) had lymph node metastasis, the degree of lymph node metastasis was (36.3 ± 30.8)% and the median was 19.0%. Univariate analysis of potential risk factors for lymph node metastasis of gastric cancer showed that tumor size, serosa invasion, heparanase expression, CD44v6 expression, nm23 expression and syndecan-1 expression were risk factors for lymph node metastasis in gastric cancer. Binary multivariate Logistic regression analysis showed that nm23, syndecan-1 and serosal invasion were independent predictors of lymph node metastasis in gastric cancer with odds ratios of 0.168, 0.126 and 22.546, respectively. Conclusion There is a high possibility of lymph node metastasis in gastric carcinoma with serosal invasion and positive expression of nm23 and syndecan-1 protein.