胃肠免疫表型标志物与胃印戒细胞癌临床病理特征及预后的关系

Relationship of clinicopathological features and prognosis of stomach and intestinal phenotype markers with signet ring cell carcinoma

目的 :探讨胃免疫表型标志物(M UC1、M UC6、M UC5AC)及肠免疫表型标志物(M UC2、CDX2)在胃印戒细胞癌中的表达及其与者临床病理特征及预后的关系。方法:采用免疫组织化学法检测85例胃印戒细胞癌胃、肠免疫表型标志物表达情况,并根据相关标志物表达水平差异,将胃印戒细胞癌分为胃型32例,肠型26例,混合型27例,分析胃、肠免疫表型标志物与胃印戒细胞癌临床病理特征及预后的关系。结果:肠免疫表型标志物MUC2、CDX2在黏膜下层浸润癌组、脉管浸润组及淋巴结转移组中阳性表达率均高于黏膜内癌组、无脉管浸润组及无淋巴结转移组,差异有统计学意义(P<0.05)。胃免疫表型标志物MUC6、MUC5AC在黏膜下层浸润癌组的阳性表达率均低于黏膜内癌组(P<0.05)。CDX2阳性表达率随着肿瘤直径的增加而显著升高(P<0.05)。经Cox风险模型显示,胃、肠免疫表型是胃印戒细胞癌5年生存率的独立危险因素(P<0.05)。经生存分析可知,胃型印戒细胞癌5年生存率显著高于肠型及混合型(P<0.05)。结论:肠型及混合型胃印戒细胞癌恶性程度较胃型高,预后效果较差。根据胃、肠免疫标志物对胃印戒细胞癌进行免疫分型将有助于临床对该类患者预后进行评估及提供治疗指导。

Objective： To investigate the relationship of expression and clinicopathological characteristics and prognosis of gastric phenotype markers （MUC1, MUC6, MUC5AC） and intestinal phenotype markers （MUC2, CDX2） in patients with gastric signet ring cell carcinoma. Methods： 85 cases of signet ring cell carcinoma of the stomach were detected with immunohistochemistry. The signet ring cell carcinoma of the stomach were divided into 32 cases of gastric type, 26 cases of in- testinal type, 27 cases of mixed type. The clinicopathological features and prognosis of stomach, in- testines phenotype markers with signet ring celt carcinoma were analyzed. Results： The intestinal immune phenotype markers MUC2, CDX2 of submucosa carcinoma group, vascular invasion and lymph node metastasis group, the positive expression group were higher than the mucosal cancer group, no vascular invasion and without lymph node metastasis group （P〈0.05）. Gastric phenotype markers MUC6, MUC5AC expression rates of early submucosal invasive carcinoma was below than mucosa（P〈0.05）. CDX2 expression increases of tumor diameter was increased（P〈0.05）. The display, stomach, intestines phenotype were the independent risk factor for gastric signet ring cell carcinoma in 5-year survival （P〈0.05） after Cox risk model. The type 5-year survival rate of signet ring cell car- cinoma of the stomach was significantly higher than that of intestinal type and mixed type（P〈0.05）. Conclusion： Intestinal type and mixed type signet ring cell carcinoma of gastric malignancy than the high-and poor prognosis. According to the stomach, intestines immune markers for gastric signet ring cell carcinoma immunophenotype this class will help clinicians assess patient prognosis and to provide treatment guidance.