E-钙连接蛋白复合体在早期胃癌的表达及意义

Expression of E-cadherin-catenins complex(E-cad,α-cat,β-cat and γ-cat) in early gastric cancer

目的探讨E-钙连接蛋白复合体(E-cad、α-cat、β-cat和γ-cat)在术前判断早期胃癌的浸润深度和淋巴结转移情况的可能性。方法用免疫组织化学方法检测E-钙连接蛋白复合体(E-cad、α-cat、β-cat和γ-cat)在早期胃癌(53例)及正常胃黏膜(10例)中的表达情况。结果E-cad、α-cat、β-cat和γ-cat在正常胃黏膜中均为正常表达,在53例早期胃癌中的异常表达率分别为64.2%、69.8%、66%和73.6%;其中黏膜内癌(n=23)异常表达率分别为61%(14/23)、65.2%(15/23)、47.8%(11/23)和56.5%(13/23),黏膜下癌(n=30)的异常表达率分别为66.7%(20/30)、73.3%(22/30)、80%(24/30)和86.7%(26/30);无淋巴结转移组(n=44)异常表达率分别为61.4%(27/44)、65.9%(29/44)、63.6%(28/44)和70%(31/44),有淋巴结转移组(n=9)异常表达率分别为77.8%(7/9)、88.9%(8/9)、77.8%(7/9)和88.9%(8/9)。β-cat和γ-cat在黏膜下和黏膜内浸润的早期胃癌中异常表达率的差异有统计学意义(P<0.05)。四种蛋白均异常表达在侵及黏膜下层并有淋巴结转移组(n=9)占77.8%(7/9),而在侵及黏膜下层但无淋巴结转移组(n=21)仅占33.3%(7/21),它们之间的差异有统计学意义(P<0.05)。结论β-cat和γ-cat异常表达提示肿瘤具有黏膜下浸润生长的倾向,而四种E-钙连接蛋白复合体均异常表达则提示有淋巴结转移可能性大。

Objective To determine the expression of E-cadherin-catenins complex（E-cad,α-cat,β-cat and γ- cat） in early gastric cancer and their relationships with biological characteristics of early gastric cancer by evaluating the invasion and the lymph nodes metastasis of eraly gastric cancer（ECG）. Methods 53 cases of EGC, who accepted radical operations from January 1997 to December 2000 in Sir Run Show Hospital were included in this study. According to the invasion depth and lymph nodes metastasis, they were divided into different sub-groups for discussion. Also the normal gastric mucosa of 10 cases with extra-gastric disease were selected as control group. Results All four proteins（E-cad,α-cat,β-eat and γ-cat） were normally expressed in control group. In early gastric cancer, the abnormal expression rates of E-cad, α-cat,β-cat and γ-cat were 64.2 %, 69.8 % ,66 % and 73.6 %, respectively. In the sub-group of mucosal invasion, the abnormal expression rates were 61% （ 14/23 ）, 65.2 % （ 15/23 ）, 47.8 % （ 11/23 ） and 56.5 % （13/23）,respectively. But in the sub-group of submucosal invasion, the abnormal expression rates were 66.7% （20/30） ,73.3（22/30） % ,80% （24/30） and 86.7% （26/30） ,respectively. In sub-group of no lymph node metastasis,the abnormal expression rates were 61.4% （27/44） ,65.9% （29/44）,63.6% （28/44） and 70% （31/44） respectively. In sub-group of lymph node metastasis, the abnormal expression rates were 77.8 % （ 7/9 ）, 88.9 % （ 8 / 9） ,77.8% （7/9） and 88.9 % （8/9） respectively. Abnormal expression of β-cat and γ-cat had significantly difference between, the sub-group of muccsal invasion and the submucosal invasion（ P 〈 0.05 ）. Abnormal expression of all four proteins appeared in 7 of 9 （77.8 % ） cases that had lymph nodes metastasis and 7 of 21 （33.3 96 ） cases that had no lymph nodes metastasis. There was significantly difference between these two sub-groups（P 〈 0.05）. Conclusion When early gastric cancer with abnormal expression of β-cat and γ-cat,it may have sub-mucosal invasion. If all the four protein are expressed abnormally in early gastric cancer, it has high possibility with lymph node metastasis.