胃癌原发灶与转移灶E-钙黏附素mRNA表达水平的比较研究

A comparative study of E-cadherin mRNA expression in primary tumors and metastatic foci of gastric cancer

目的 评价E 钙黏附素 (E CD)mRNA在胃癌原发灶、淋巴结转移灶和腹腔液中的表达水平及其与胃癌生物学行为的关系。方法 采用逆转录聚合酶链反应 (RT PCR)对 35例进展期胃癌癌旁正常黏膜、原发癌组织、转移淋巴结和腹腔液中E CDmRNA水平进行检测 ,并与胃癌的生物学行为和腹膜转移相关因素进行比较。结果 全组癌旁正常黏膜、原发癌组织、转移淋巴结和腹腔液均检出E CDmRNA。与癌旁正常黏膜相比 ,胃癌原发组织E CDmRNA表达水平明显减弱 (P <0 .0 1) ,在浸润型、未分化型、弥漫状生长、侵透浆膜和Ⅲ、Ⅳ期胃癌中 ,其表达水平明显降低 (P <0 .0 5 )。随着淋巴结转移数目增加 ,胃癌原发灶中E CDmRNA表达水平也显著降低 (P <0 .0 5 ) ,但淋巴结转移灶中E CDmRNA表达明显增高 ,与其分化程度无关。转移淋巴结与相应原发灶的E CDmRNA表达指数差值在浸润型、未分化型、弥漫状生长、侵透浆膜、淋巴结转移严重及Ⅲ、Ⅳ期胃癌组织中明显增高 (P <0 .0 5 )。腹腔液中E CDmRNA表达指数在侵透浆膜、腱状及多彩型浆膜、ECC阳性者明显增高 (P <0 .0 1)。结论 胃癌原发灶的E CDmRNA表达水平降低 ,且表达水平与胃癌的恶性生物学行为呈正相关 ;胃癌转移淋巴结的E CDmRNA表达水平增高 ,并与胃癌的恶性生物学行为呈负相关。

Objective To evaluate the expression level of E cadherin (E CD) mRNA in gastric cancer and its relation to biological behavior. Methods The expression level of E CD mRNA was examined by RT PCR in primary tumors, nearby tumor free tissues, metastatic lymph nodes and peritoneal lavage fluid from 35 cases with advanced gastric cancer. Results All the specimens expressed E CD mRNA. The expression level in primary tumors was significantly decreased compared with that in nearby tumor free tissues ( P <0.01). The decrease in E CD expression was more marked in poorly differentiated, diffusely growing tumors invading through serosal membrane. E CD expression in the primary tumor was more significantly decreased with the increase in the number of lymph nodes(LNS) metastasized and progression of the clinical stage. However, E CD expression level was significantly increased in metastatic LNs. The difference in E CD mRNA level between metastatic LN and the primary tumor was increasing with progression of the disease. The expression level of E CD mRNA in peritoneal lavage fluid was increased in patients whose tumor had penetrated through serosa and larvage fluid was positive on exfoliative cytologic examination. Conclusion E CD mRNA expression in primary tumors of gastric cancer is negatively correlated with the malignant behavior of the tumor. Nonetheless, that in the metastatic lymph nodes is increased with the progression of the disease.