酸性粘蛋白抗原在肠型胃癌自然史的表达规律及其标志物价值研究

Expression of Acidic Mucins in Natural History of Intestinal Gastric Cancer and Its Biomarker Values

目的:阐明两类酸性粘蛋白糖链抗原在肠型胃癌自然史各阶段的表达规律,为肠型胃癌自然史研究提供参考指标。方法:用唾液酸化粘蛋白特异性单克隆抗体5E2、6C10和硫酸化粘蛋白特异性单克隆抗体AH5进行高发区胃癌和癌前疾病组织的LSAB法免疫组化染色。结果:McAb5E2和McAb6C10在慢性浅表性胃炎组织与腺泡上皮细胞胞浆内容物反应,在肠化生、异型增生组织与杯状细胞空泡反应,在胃癌组织与癌细胞胞浆反应。McAbAH5在慢性浅表性胃炎、肠化生组织与间质组织反应,在异型增生和胃癌组织与腺上皮细胞胞浆反应。McAb5E2在肠型胃癌自然史各阶段组织检测的阳性率:慢性浅表性胃炎组为40.0%,重度肠上皮化生组为63.0%,早期胃癌组为16.7%,进展期胃癌为42.0%。McAb6C10的阳性率与5E2类似。McAbAH5在异型增生组阳性率为9.8%,早期胃癌组为83.3%,进展期胃癌组为84.0%。结论:两类粘蛋白的三株单克隆抗体可以反映出肠型胃癌自然史中从肠上皮化生到癌,唾液酸化粘蛋白的表达逐渐下降,而硫酸化粘蛋白抗原的表达逐渐上升的表达规律,这三株抗体可以做为肠型胃癌自然史研究的新工具。

Objective:To elucidate the expressional character of the sialyl-mucins and sulfated-mucins during the progress of natural history of intestinal gastric cancer and to get a new supplemental gastric cancer diagnostic index.Methods:LSAB immunohistochemical staining was performed on217samples of formalin fixed,paraffin wax embedded human gastric tissues.Thirty-five cases were chronic superficial gastritis,63metaplasia,51dysplasia,18early cancer and50advanced cancer.All of the cases came from one of the high-risk gasteric cancer area in China.The specific monoclonal6C10of sialyl-mucin and AH5of sulfated-mucin were de-tected using LSAB immunohistochemical staining.Results:The positive rates of McAb6C10were25.7%for chronic superficial gastritis,48.1%for severe metaplasia,5.5%for early cancer and14%for advanced gastric cancer.Being an index of diagnosing gastric cancer,its sensitivity rate was83.8%and its specificity rate was96.6%,while the positive predictive rate was91.2%and the negative predictive rate was92.9%.The Youden's index was0.804.Conclusion:The sialyl-mucin and sulfated-mucin are expressed differently during the progress of natural history of intestinal gastric cancer.The specific McAbAH5is a very good supplemental marker in diagno-sis.of gastric cancer.