趋化因子受体CCR7在胃癌中的表达及其与淋巴结转移的关系

Expression of chemokine receptor CCR7 and its association with lymph node metastasis in gastric carcinoma

目的探讨趋化因子受体CCR7的表达对预测胃癌淋巴结转移的临床价值。方法对132例行胃癌根治术和30例内镜活检的胃癌组织标本采用免疫组化法检测CCR7的表达。结果CCR7在56.8%的病例中呈阳性表达。CCR7在伴有淋巴结转移病例中的表达显著高于无淋巴结转移者(P<0.001);其与肿瘤大小(P<0.01)、浸润深度(P<0.001)、淋巴管浸润(P<0.001)和TNM分期(P<0.001)相关,并与多层螺旋CT(MSCT)和病理检查判断的淋巴结转移密切相关(P<0.05,P<0.01);但与年龄、性别、肿瘤位置、Lauren分类和血管浸润无关。在回顾性研究中,CCR7表达对胃癌淋巴结转移判断的敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和准确率分别为83.1%、73.8%、78.7%、78.9%和78.8%;在前瞻性研究中,CCR7表达对胃癌淋巴结转移判断的敏感性、特异性、PPV、NPV和准确率分别达85.0%、60.0%、80.9%、66.7%和76.7%。结论CCR7表达与胃癌淋巴结转移密切相关,对内镜活检组织检测CCR7的表达有助于预测胃癌淋巴结转移及决定淋巴结清扫的手术范围。CCR7可能成为胃癌治疗的新靶点。

Objective To examine the expression of chemokine receptor CCR7 in gastric carcinoma and to investigate its association with lymph node metastasis of gastric carcinoma and its value in predicting lymph node metastasis. Methods The expression of CCR7 in endoscopic biopsy specimens from 30 preoperative patients with gastric carcinoma and in gastric carcinoma tissues from 132 patients who underwent curative gastrectomy was examined by immunohistochemistry. Among the 132 patients, 46 patients preoperatively underwent multi-slice spiral CT (MSCT) examination. Results CCR7 was positively expressed in 56.8%of the patients. CCR7 expression was significantly higher in the patients with lymph node metastasis than those without lymph node metastasis (P< 0.001) and was also correlated with tumor size (P< 0.01), depth of invasion (P< 0.001), lymphatic invasion (P< 0.001), and TNM stage (P< 0.001),but not with age at surgery, gender, tumor location, Lauren classification, and vascular invasion. Among the 46 patients who underwent MSCT examination, CCR7 expression was closely correlated with lymph node metastasis determined not only by pathological examination but also by MSCT examination (P< 0.01,P< 0.05). In the retrospective study, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of CCR7 expression for lymph node metastasis was 83.1%, 73.8%, 78.7%, 78.9%, and 78.8%, respectively. In the prospective study, the sensitivity, specificity, PPV, NPV, and accuracy of CCR7 expression was 85.0%, 60.0%, 80.9%, 66.7%, and 76.7%, respectively. Conclusion The expression of CCR7 is related to lymph node metastasis of gastric carcinoma,and the examination of CCR7 expression in endoscopic biopsy specimens is useful in predicting lymph node metastasis of gastric carcinoma and determining the extent of surgical lymph node resection.