上皮钙黏附素在胃癌中表达的意义及诱导化疗后的改变

The Expression of E-cadherin in Gastric Cancer and Changed after Neoadjuvant Chemotheraph

目的:探讨上皮钙黏附素(E-cd)在胃癌中的表达与胃癌生物学行为的关系,以及术前诱导化疗后E-cd在胃癌及癌旁组织中的变化,以确定术前应用短程化疗的意义.方法:应用免疫组织化学(S-P)法测定62例胃癌组织及癌旁组织E-cd的表达水平,其中32例以15 mg/(kg@d)5-氟尿嘧啶(5-FU)术前进行1～5天的化疗,余30例为对照组,术中收集胃癌及癌旁组织标本.结果:E-cd在正常胃黏膜皆表达强阳性,在胃癌组织弱阳性及阴性表达占70%(21/30),E-cd的表达与胃癌细胞分化相关.5-FU术前化疗可以明显提高胃癌组织的E-cd阳性表达率(与对照组相比,P＜0.01),而且5-FU≥3.0g组与5-FU＜3.0g组之间差异具有显著性(P＜0.025);在癌旁组织中5-FU≥3.0 g组与非化疗组之间E-cd阳性表达率差异有显著性(P＜0.025).结论:E-cd的存在与否可能决定胃癌细胞的分化程度,术前应用5-FU诱导化疗可以提高胃癌细胞的阳性表达率,可以提高癌旁细胞的阳性表达率,术前诱导化疗可能减弱胃癌细胞的侵袭性.

Objective: To evaluate the expression of E-cadherin(E-cd) after preoperative chemotheraph and the relationship between the E-cd expression and biological behavior of gastric cancer. Methods: E-cd expression were measured with immunohistochemical staining (S-P) in 62 cases of gastric cancers. Thirty-two cases received preoperative chemotherapy of 5-FU for 1-5 days. The other 30 cases without preoperative chemotherapy were in control group. Results: A positive expression of E-cd were found in normal gastric mucosa, in contrast, the E-cadherin expression was significantly reduced in the gastric tumor tissues. E-cd expression was reduced in undifferentiated tumor compare with well-differentiated cancer (P < 0. 01) . Positive expression of E-cd in chemotherapy group has significantly higher than control group (P < 0. 01), and there were significant difference between group which had high dosages of 5-FU (5-FU>3. 0 g) than lose dosage group (5-FU < 3. 0 g). As the mucosa adjacent to carcinoma, the E-ed expression has significant difference between high dosage group and control group (P < 0. 025). Conclusion: Down-regulation of E-cd expression correlate with poor biological behavior of gastric carcinoma. Preoperative chemotherapy might improve the E-cd expression rate in gastric carcinoma and normal mucosa adjacent carcinoma.