摘要
目的探讨胃肠道间质瘤（GIST）中P16基因启动子区甲基化状态和P16蛋白在GIST中的表达及其意义。方法对62例随访资料完整的GIST患者，应用甲基化特异性聚合酶链反应法和免疫组化EnVisionTM法，检测瘤组织中P16基因启动子区甲基化状态和P16蛋白的表达。结果本组进展性疾病（PD）21例，非PD41例。Fletcher分级：极低度侵袭危险性（I级）13例；低度侵袭危险性（Ⅱ级）12例；中度侵袭危险性（Ⅲ级）19例；高度侵袭危险性（Ⅳ级）18例。P16甲基化19例，非甲基化43例。P16蛋白阳性细胞数小于50％20例，50％～75％15例，大于75％27例。在Fletcher分级中，P16基因启动子甲基化和P16蛋白表达差异有统计学意义（分别为P〈0．05和P〈0．01）；Ⅳ级中P16基因启动子甲基化占50％．P16阳性细胞数小于50％者占65％。P16蛋白表达阳性不同强度之间PD值比较差异有统计学意义（P〈0．01）；P16阳性细胞数小于50％者PD占95％；而50％以上者组间PD值比较，P〉0．05；差异无统计学意义。P16阳性细胞数小于50％者的肿瘤组织P16甲基化占75％，而P16阳性细胞数大于50％者P16甲基化仅占10％，两组间差异有统计学意义（P〈0．01）。结论在GIST组织中，P16蛋白低表达、P16基因启动子甲基化预示肿瘤预后差。
Objective To study the methylation status of P16 gene promoter and the expression of P16 protein in gastrointestinal stromal tumors（GIST） and to explore the prognostic value. Methods Methylation status of the P16 promoter was detected by methylation-specific polymerase chain reaction （MSP） and the expression of P16 protein by immunohistochemistry in 62 patients with GIST. Results The status of P16 gene methylation and the expression of P16 protein were significantly different among the patients with different subclassification of GIST using Fletcher＇s scheme （P 〈 0.05, P 〈 0.01 ）. And there were significant differences in progressive disease （PD） among various levels of P16 expression （P 〈 0.01 ）. P16 gene methylation was closely related to P16 protein. P16 gene methylation accounted for 75% in the tumor tissue with less than 50% P16 positive cells, and accounted for only 10% in the tumor tissue with more than 50% P16 positive cells （P 〈 0.01 ）. Conclusion P16 immunohistochemical assessment can be used as a prognostic index for GIST. The patients with more than 50% fraction of cells with low P16 immunostaining have poor prognosis.
出处
《中华胃肠外科杂志》
CAS
2007年第4期372-375,共4页
Chinese Journal of Gastrointestinal Surgery
基金
山西省自然科学基金（2006011122）
作者简介
通讯作者：梁建芳，电子邮箱：jniang2000@yahoo.com.cn.
