Cadherin 17在胃癌中的表达与临床意义

目的探讨钙粘蛋白17(CDH17)在胃癌中表达意义及与其它部位腺癌的鉴别价值。方法选取2018年7月至2023年6月本院收治的消化系统来源原发性腺癌348例,包括胃癌114例,结直肠癌150例,胰胆管癌55例以及非消化系统来源的原发性腺癌29例。检测CDH17和尾型同源盒转录因子-2(CDX2)不同腺癌表达水平。结果发生肠上皮化生的胃黏膜上皮细胞CDH17呈阳性表达。各组腺癌CDH17、CDX2阳性表达率分别为胃癌74.6%、79.8%;结直肠癌95.3%、98.7%;胰胆管癌34.5%、21.8%,非消化系统腺癌中未见表达,CDH17、CDX2在各组间差异均有统计学意义(P<0.001)。胃癌、结直肠癌与胰胆管癌中CDH17和CDX2表达呈正相关(P<0.001)。通过对CDH17和CDX2的联合检测,以任何一种标志物阳性作为阳性结果,胃癌中阳性表达率为88.6%,与单一标志物检测相比,敏感性提高了14%和8.8%;胰胆管癌中两种标志物均阴性的表达率为60%,CDH17和CDX2联合检测结果在胃癌与胰胆管癌中有统计学意义(P<0.001)。胃癌CDH17表达水平与Lauren分型相关(P<0.05),但与肿瘤大小、T分期、脉管神经侵犯、淋巴结或远处转移不相关。结论CDX2是目前消化系统肿瘤较特异的标记物,但在胃癌中的表达相对偏低,在胰胆管癌中少量表达。CDH17在胃癌中高表达,其表达水平与胃癌Lauren分型肠型相关。CDH17在胃癌中的阳性表达率低于结直肠癌,但明显高于胰胆管癌和非消化系统腺癌。CDH17可作为消化系统新型标志物,联合CDX2检测,有助于消化系统腺癌的组织来源判断。

Objective To investigate the significance of the expression of calmodulin 17(CDH17)in gastric cancer and its differentiation value from adenocarcinoma in other sites.Methods 319 cases of primary adenocarcinomas of digestive system origin in the last 5 years were collected,including 114 cases of gastric cancer,150 cases of colorectal cancer,55 cases of pancreaticobiliary cancer,and 29 cases of primary adenocarcinomas of non-digestive system origin.The expression levels of CDH17 and tail-type homology cassette transcription factor-2(CDX2)in different adenocarcinomas were detected by immunohistochemical methods.Results Gastric mucosal epithelial cells in which intestinal epithelial hyperplasia occurred showed positive expression of CDH17.The positive expression rates of CDH17 and CDX2 in adenocarcinoma in each group were 74.6%(85/114)and 79.8%in gastric cancer;95.3%and 98.7%in colorectal cancer;34.5%and 21.8%in pancreatico-biliary cancer,and the expression was not seen in non-digestive adenocarcinoma,respectively,the differences of CDH17 and CDX2 were statistically significant among all groups(P<0.001).The expression of CDH17 and CDX2 was positively correlated in gastric,colorectal and pancreaticobiliary cancers(P<0.001).The positive expression rate was 88.6%in gastric cancer by the combined detection of CDH17 and CDX2 with positive result of either marker as positive result,which increased the sensitivity by 14%and 8.8%compared with the single-marker detection;the expression rate of both markers negative in pancreaticobiliary carcinoma was 60%,and the combined detection of CDH17 and CDX2 The results were statistically significant in gastric cancer and pancreaticobiliary cancer(P<0.001).The expression level of CDH17 in gastric cancer was correlated with Lauren staging(P<0.05),but not with tumour size,T stage,vascular nerve invasion,lymph node or distant metastasis.Conclusion CDX2 is currently a more specific marker for tumours of the digestive system,but its expression is relatively low in gastric cancer,and a small amount in pancreaticobiliary carcinoma.CDH17 is highly expressed in gastric cancer,and its expression level correlates with the Lauren typing bowel phenotype of gastric cancer.Positive expression of CDH17 is lower than that of colorectal cancer in gastric cancer but significantly higher than that of pancreaticobiliary carcinoma and non-digestive adenocarcinomas.CDH17 can be used as a a novel marker for the digestive system,and in combination with CDX2 detection,it can help to determine the tissue origin of adenocarcinoma of the digestive system.