E-钙黏附素及α-链接素的表达与胃癌生物学行为及淋巴结转移规律的关系

The clinical significance of E-cadherin and alpha-catenin expression in human gastric cancer

目的 探讨上皮细胞黏附分子E 钙黏附素 (E CD)及链接素 α(α CA)在胃癌的表达及其与胃癌生物学行为的关系。 方法 采用免疫组化技术 (ABC法 )对 70例手术切除新鲜胃癌组织进行了E CD及α CA表达情况的检测 ,每例均行腹腔脱落癌细胞和系统病理学检查。 结果 胃癌组织E CD及α CA表达阳性率分别为 38 6 %和 2 8 6 %。在侵袭型、未分化型、弥漫状生长、侵透浆膜(T3/T4)、淋巴结转移阳性及Ⅲ、Ⅳ期胃癌中 ,E CD及α CA表达显著减弱 (P <0 0 2 5～ 0 0 0 5 )。在淋巴结多数转移 (>5个 ) ,转移度 >5 0 %及转移至Ⅱ站以远的胃癌中 ,E CD及α CA表达亦明显减弱 ,且α CA比E CD降低更明显 (P <0 0 5～ 0 0 0 5 )。E CD(+ ) /α CA(- )及E CD(- ) /α CA(- )组淋巴结转移率和脱落癌细胞阳性率均高于E CD(+ ) /α CA(+ )组 (P <0 0 5～ 0 0 0 5 ) ,但E CD(+ ) /α CA(- )组肝转移率高于E CD(+ ) /α CA(+ )及E CD(- ) /α CA(- )组 (P <0 0 0 5 )。 结论 E CD/α CA联合检测对评估胃癌侵袭深度、淋巴结转移程度、肝转移、TNM分期及腹腔癌细胞脱落状态有较大意义 ,其中α CA比E CD表达更敏感。

Objective To evaluate the expression of cell adhesion molecules E-cadherin (E-CD) and α-catenin (α-CA) in relation to biologic behavior of gastric cancer. [WT5”HZ]Methods The level of E-CD and α-CA expression was examined in 70 cases of primary gastric cancer by immunohistochemical technique. [WT5”HZ]Results The rate of E-CD and α-CA expression was significantly reduced in gastric cancer with more prominent malignant phenotype, such as tumor in stage III/IV with poor cell differentiation, invasion through serosa and lymph node (LN) metastasis.With the increase in the number and frequency of LN metastasis and its dissemination distal to second group LNs, the reduction in expression of the two adhesion molecules was increasingly significant. The frequency of LN metastasis and shed cancer cells in the peritoneum in patients with E-CD(-)/α-CA(-) and E-CD(+)/αCA(-) cancer were significantly higher than those in patients with E-CD(+)/α-CA(+) tumor. Liver metastasis was most frequent in all cases with E-CD(+)/α-CA(-) tumor. Conclusion Down regulation of E-CD and/or α-CA correlates with the malignant behavior of gastric cancer. Examination of E-CD and α-CA expression in primary gastric cancer helps evaluate its intensity of LN metastasis, TNM staging and prognosis.