RAGE和sRAGE在胃癌中的表达及其临床意义

Clinical significance of RAGE and sRAGE expressions in gastric cancer

摘要:

通过检测胃癌组织晚期糖基化终末产物受体（RAGE）和血清可溶性RAGE（sRAGE）表达水平，探讨其在胃癌发生过程中的作用及其临床意义。方法为研究胃癌组织RAGE表达水平，纳入非糖尿病胃癌患者（Ⅰ～Ⅲ期）38 例的病理组织蜡块，10 例癌周组织（癌组织边缘≥5 cm）为对照，以免疫组织化学法染色评价胃癌组织RAGE 表达水平。为检测外周血sRAGE表达水平，采集38 例胃癌患者（Ⅰ～Ⅲ期）术前24 h、术后7 d肘静脉血2 ml，以30例健康捐献者外周血为对照，分离血清，以酶联免疫吸附法检测sRAGE浓度。结果RAGE 在正常组织和胃癌组织均有表达，胃癌组织表达水平更高（p <0.05），而与TNM 分期和病理组织分型无关（p >0.05）。胃癌患者手术前后血清sRAGE 表达水平高于健康捐献者（p <0.05），术后血清sRAGE水平降低（p <0.05），但Ⅱ、Ⅲ期患者术后sRAGE 水平高于Ⅰ期患者（p <0.05）。结论胃癌组织RAGE 表达水平上调，可作为病理组织学辅助诊断指标；胃癌患者血清sRAGE 水平上调作为术前辅助诊断指标，有一定临床意义。

Abstract:

To reveal the clinical significance of the expressions of receptor of advanced glycation end product (RAGE) and soluble RAGE (sRAGE) in gastric cancer and their correlations with tumor differentiation. Methods To study the expression of RAGE in gastric carcinoma tissues, the paraffin-embedded cancerous tissues of 38 patients with stageⅠ-Ⅲgastric cancer without diabetes mellitus were enrolled in this study and 10 samples of adjacent tissues (distance from the edge of the cancer tissues ≥5 cm) as control group. RAGE was analyzed by immunohistochemical staining. To detect the concentration of serum sRAGE, peripheral blood of the 38 gastric cancer patients was collected about 24 hours before operation and on the 7th day after surgery, and the peripheral blood of 30 healthy donors was collected as control group. The concentration of serum sRAGE was analyzed by enzyme-linked immunosorbent assay. Results RAGE was expressed in the adjacent tissues and the gastric tumor tissues, but higher in the gastric tumor tissues (p <0.05). RAGE was not correlated with TNM stage or pathological type of the cancer (p > 0.05). The expression levels of preoperative and postoperative serum sRAGE from the 38 patients with gastric cancer were higher than that from the healthy donors (p < 0.05). The sRAGE expression level decreased after radical gastrectomy (p < 0.05). After the surgery, compared with the patients with stage Ⅱor Ⅲgastric cancer, the patients with stage Ⅰgastric cancer had a lower expression level of serum sRAGE (p < 0.05). Conclusions RAGE expression is up-regulated in gastric tumor tissues, and is helpful to histopathological diagnosis. Serum sRAGE concentration increases in the patients with stage I-Ⅲgastric cancer, which expresses a certain clinical significance in preoperative tumor screening.