摘要目的探讨上皮细胞黏附分子(EpCAM)和紧密连接蛋白(Claudin-18)在胃癌中的表达及临床意义. 方法收集64例手术患者保存的胃癌标本,病理诊断标准均参照WHO标准.采用免疫组织化学法进行染色,检测上述所有标本中EpCAM和Claudin-18的表达,比较EpCAM与Claudin-18的表达和胃癌临床病理参数之间的关系,并采用Cox比例风险回归模型分析胃癌患者预后与EpCAM和Claudin-18表达的关系. 结果 EpCAM的表达比例随肿瘤的增大以及远处转移的发生而升高(x 2 =4.526、36.090,P=0.033、0.000);不同年龄、肿瘤TNM分期、生长方式、浸润深度及远处转移患者Claudin-18的蛋白表达差异有统计学意义(均P＜0.05);Cox回归模型分析结果显示,仅肿瘤大小和远处转移是影响胃癌患者生存的主要危险因素(RR=50.076、1.617,P=0.016、0.032),EpCAM和Claudin-18的表达均不是独立的危险因素(均P＞0.05). 结论 EpCAM与Claudin-18与胃癌侵袭性密切相关,但两者的异常表达不是胃癌患者预后的独立危险因素.

abstractsObjective To investigate the expression and clinical significance of epithelial cell adhesion molecule(EpCAM) and Claudin-18 in gastric cancer.Methods Surgical specimens of gastric cancer were taken from 64 patients.The histological diagnostic criteria were based on WHO standards.Immunohistochemical staining was used to detect expression levels of EpCAM and Claudin-18 in all samples.The relationship between the expression of EpCAM and Claudin-18 and clinicopathological parameters of gastric cancer was analyzed.Correlations of the prognosis of gastric cancer patients with EpCAM and Claudin-18 expression were analyzed using the Cox proportional hazards regression model.Results The positive expression rate of EpCAM was elevated with the increase in tumor size and the occurrence of distant metastasis(x2 =4.526 and 36.090,P=0.033 and 0.000).There were significant differences in Claudin-18 protein expression among different age,TNM stage,growth pattern,depth of invasion and distant metastasis patients(all P＜0.05).Cox regression model analysis showed that tumor size and distant metastasis were the main risk factors affecting the survival of patients with gastric cancer (RR =50.076 and 1.617,P =0.016 and 0.032),while levels of EpCAM and Claudin-18 were not independent risk factors (both P ＞ 0.05).Conclusions EpCAM and Claudin-18 are closely related to the invasiveness of gastric cancer,but abnormally high levels of EpCAM and Claudin-18 are not independent risk factors for the prognosis of gastric cancer patients.