趋化因子受体CCR7在胃癌及转移淋巴结中的表达及其意义

Expression and clinical significance of chemokine receptor CCRT in gastric carcinoma and its corresponding lymph node metastasis

目的探讨胃癌原发灶及淋巴结转移灶中趋化因子受体CCR7的表达特点及其于临床病理特征的关系。方法对51例行胃癌根植术的胃癌组织标本及33例淋巴结转移灶采用免疫组化法检测CCR7表达。结果CCR7在62.7%(32/51)胃癌组织中呈阳性表达,33例胃癌原发灶和淋巴结转移灶中CCR7高表达的阳性率分别为84.8%(28/33),81.8%(27/33),两部位CCR7表达具有较高的同源性。CCR7表达与淋巴结转移(P<0.01),侵润深度(P<0.01),肿瘤分期(P<0.01)密切相关,但与手术年龄,性别,肿瘤大小及分化程度无关。CCR7表达对胃癌淋巴结转移判断的敏感性,特异性,阳性预测值及阴性预测值分别为84.8%(28/33),77.8%(14/18),87.5%(28/32),73.7%(14/19)。结论CCR7表达与胃癌淋巴结转移密切相关,CCR7在胃癌原发灶及转移淋巴结中的表达具有较高的同源性,CCR7表达对胃癌手术方式的选择及非手术治疗选择靶点具有指导价值。

Objective To investigate the expression of chemokine receptor CCR7 in gastric carcinoma and its corresponding lymph node metastasis and the relations with clincopathologic characterics.Methods The expression of CCR7 in gastric carcinoma tissues from 51 patients who underwent curative gastrectomy and 33 cases of lymph node Expression and clinical significance of chemokine receptor CCR7 in gastric carcinoma and its corresponding lymph node metastasis was examined by immunohistochemistry. Results CCR7 expression was positively expressed in 62.7 % （32/51）of the patients. The high expression rate of CCR7 in 33 cases of gastric primary lesions and corresponding lymph node metastases was 84.8% （28/33）, 81.8% （27/33）, respectively. 81.8% （27/ 33） metastasic positive cases,there is a homogeneous expression of CCR7 in the primmy lesions and metastasic lymph node. CCR7 expression was signliicancely higher in the patients with lymph node metastasis than those without lymph node metastasis（ P 〈 0.001）, ,and was also conrrelated with depth ofinvasion（P〈0.001）,TNM stage（P 〈 0.001）,but not with age at surgery, gender, tumor size and di-fferenfly degree. In the retrospectively study, the sensifivity, specificity, posifivepredicfivovalue（PPV）, negafivdy predictive value（NPV） of CCR7 expression for lymph rode metastasis was 84.8% （28/33） （/7.8% （14/18） ,87.5% （28/32） ,73.7% （14/19）, respectively. Conclusion The expression of CCR7 is closely correlated to lymph node metastasis of gastric carcinoma. In most of the metastasic positive cases,there is a homogeneous expression of CCR7 in the primary lesions and metastasic lymph node. Evalution of the CCR7 expression seems to the improve the selection of patients for local treatment and might constitute targets for nonsurglcal theraphy.