AIM: To explore the biological behavior of gastric carcinoma micrometastasis (MM) with a marker of cytokeratin 18 (CK18) and to evaluate the clinical stage of gastric carcinoma and its prognosis. METHODS: Reverse tran...AIM: To explore the biological behavior of gastric carcinoma micrometastasis (MM) with a marker of cytokeratin 18 (CK18) and to evaluate the clinical stage of gastric carcinoma and its prognosis. METHODS: Reverse transcription-polymerase chain reaction (RT-PCR) was used to examine the expression of CK18 mRNA in 298 lymph nodes from 35 patients with gastric carcinoma and 20 lymph nodes from 10 patients with chronic peptic ulcer and gastric perforation diagnosed by pathological examination and surgery.CK18 mRNA expression of peripheral blood from 54 patients with gastric carcinoma and 10 healthy people were also examined.RESULTS: Expression of CK18 mRNA was not found in 10 patients with benign pathological changes.CK18 mRNA expression in gastric carcinoma tissues was strongly positive. In gastric carcinoma patients,pathological examination revealed that 99 of 298 (33.2%)lymph nodes were positive, while RT-PCR showed that 133 of 298 (44.6%) lymph nodes had expression of CK18 mRNA. The difference was significant (P＜0.05).Among the 199 negative lymph nodes identified by pathological examinations, 34 (17.1%) displayed positive expression of CK18 mRNA by RT-PCR. The positive expression of CK18 mRNA was associated with lymph node micrometastasis (LMM) of gastric carcinoma. CK18 mRNA was negatively expressed in all 10 healthycases and positively expressed in 38.9% of 54 blood specimens from gastric carcinoma patients. The positive rate was not correlated with tumor invasion of gastric carcinoma,but was significantly associated with TNM stage, lymph node metastasis (P=0.0290, P＜ 0.05) and tumor differentiation (P= 0.2956, P＜0.05).CONCLUSION: RT-PCR with CK18 mRNA as a molecular marker is highly sensitive and specific in detecting LMM of gastric carcinoma. It can benefit the diagnosis of MM and guide studies on biological behavior, clinical phase,and therapy as well as relapse monitoring.展开更多
Objective： To investigate the genotypes of well-differentiated non-cardiac gastric adenocarcinoma and their clinicopathological significance. Methods： Sixty-four cases of well-differentiated non-cardiac gastric ade...Objective： To investigate the genotypes of well-differentiated non-cardiac gastric adenocarcinoma and their clinicopathological significance. Methods： Sixty-four cases of well-differentiated non-cardiac gastric adenocarcinoma were included in this study. The expressions of intestinal phenotypic markers including CDX2, MUC2, Li-cadherin, CD10, Hepatocyte（Hep） and Villin, and gastric phenotypic markers including MUC5AC and pS2 were detected immunohistochemically. Based on the expressions of phenotypic markers, 64 cases can be divided into four phenotypes. Cases only expressing intestinal phenotypic markers were classified as intestinal phenotype; cases only expressing gastric phenotypic markers as gastric phenotype; cases expressing both intestinal and gastric phenotypic markers as gastrointestinal phenotype; and cases expressing neither intestinal nor gastric phenotypic marker as null phenotype. The association of phenotype and clinic-pathological parameters was analyzed. We also detected the expressions of markers related to the development and progression of cancer, including Rb, P53, c-Met, MIF, TGF-β-RII, β-catenin, CD44v6 and E-cadherin. Results： Of 64 cases, 33（51.6%） were intestinal type, 3（4.7%） were gastric type, 25（39.1%） were gastrointestinal type and 3（4.7%） were null type. Fifty-eight cases were either intestinal or gastrointestinal type, which accounted for 90.6% of all the cases. In addition, there was an association between phenotype and biological behaviors （invasion or metastasis）. The biological behaviors of intestinal and gastrointestinal type were better than gastric type. Compared with intestinal, gastric and gastrointestinal types, the biological behaviors of null type were the most aggressive. The biological behaviors of gastric carcinoma tended to be better as the number of expression of intestinal markers increased. Expression of markers related to the development and progression of cancer was not significantly correlated with phenotypes and biological behaviors of well-differentiated gastric carcinoma. Conclusion： Well-differentiated gastric adenocarcinomas are heterogeneous phenotypically. They can be divided into four phenotypes, namely intestinal, gastric, gastrointestinal and null types. Present findings show that well-differentiated gastric adenocarcinoma in the WHO classification is highly consistent with intestinal type gastric cancer in the Lauren classification. Expression of phenotypic marker is of certain clinic-pathologic significance.展开更多
基金Supported by the Natural Science Foundation of Jilin Province,No. 20010594
文摘AIM: To explore the biological behavior of gastric carcinoma micrometastasis (MM) with a marker of cytokeratin 18 (CK18) and to evaluate the clinical stage of gastric carcinoma and its prognosis. METHODS: Reverse transcription-polymerase chain reaction (RT-PCR) was used to examine the expression of CK18 mRNA in 298 lymph nodes from 35 patients with gastric carcinoma and 20 lymph nodes from 10 patients with chronic peptic ulcer and gastric perforation diagnosed by pathological examination and surgery.CK18 mRNA expression of peripheral blood from 54 patients with gastric carcinoma and 10 healthy people were also examined.RESULTS: Expression of CK18 mRNA was not found in 10 patients with benign pathological changes.CK18 mRNA expression in gastric carcinoma tissues was strongly positive. In gastric carcinoma patients,pathological examination revealed that 99 of 298 (33.2%)lymph nodes were positive, while RT-PCR showed that 133 of 298 (44.6%) lymph nodes had expression of CK18 mRNA. The difference was significant (P＜0.05).Among the 199 negative lymph nodes identified by pathological examinations, 34 (17.1%) displayed positive expression of CK18 mRNA by RT-PCR. The positive expression of CK18 mRNA was associated with lymph node micrometastasis (LMM) of gastric carcinoma. CK18 mRNA was negatively expressed in all 10 healthycases and positively expressed in 38.9% of 54 blood specimens from gastric carcinoma patients. The positive rate was not correlated with tumor invasion of gastric carcinoma,but was significantly associated with TNM stage, lymph node metastasis (P=0.0290, P＜ 0.05) and tumor differentiation (P= 0.2956, P＜0.05).CONCLUSION: RT-PCR with CK18 mRNA as a molecular marker is highly sensitive and specific in detecting LMM of gastric carcinoma. It can benefit the diagnosis of MM and guide studies on biological behavior, clinical phase,and therapy as well as relapse monitoring.
基金supported by grants from Beijing Municipal Science & Technology commission NOVA Program(No.2005B-44)the Key Technology Research and Development Program(No. 2002BA711A06)+1 种基金the National"973"Basic Research Program of China(No.1998051203)the National"863"High-Tech Res & Dev Program of China
文摘Objective： To investigate the genotypes of well-differentiated non-cardiac gastric adenocarcinoma and their clinicopathological significance. Methods： Sixty-four cases of well-differentiated non-cardiac gastric adenocarcinoma were included in this study. The expressions of intestinal phenotypic markers including CDX2, MUC2, Li-cadherin, CD10, Hepatocyte（Hep） and Villin, and gastric phenotypic markers including MUC5AC and pS2 were detected immunohistochemically. Based on the expressions of phenotypic markers, 64 cases can be divided into four phenotypes. Cases only expressing intestinal phenotypic markers were classified as intestinal phenotype; cases only expressing gastric phenotypic markers as gastric phenotype; cases expressing both intestinal and gastric phenotypic markers as gastrointestinal phenotype; and cases expressing neither intestinal nor gastric phenotypic marker as null phenotype. The association of phenotype and clinic-pathological parameters was analyzed. We also detected the expressions of markers related to the development and progression of cancer, including Rb, P53, c-Met, MIF, TGF-β-RII, β-catenin, CD44v6 and E-cadherin. Results： Of 64 cases, 33（51.6%） were intestinal type, 3（4.7%） were gastric type, 25（39.1%） were gastrointestinal type and 3（4.7%） were null type. Fifty-eight cases were either intestinal or gastrointestinal type, which accounted for 90.6% of all the cases. In addition, there was an association between phenotype and biological behaviors （invasion or metastasis）. The biological behaviors of intestinal and gastrointestinal type were better than gastric type. Compared with intestinal, gastric and gastrointestinal types, the biological behaviors of null type were the most aggressive. The biological behaviors of gastric carcinoma tended to be better as the number of expression of intestinal markers increased. Expression of markers related to the development and progression of cancer was not significantly correlated with phenotypes and biological behaviors of well-differentiated gastric carcinoma. Conclusion： Well-differentiated gastric adenocarcinomas are heterogeneous phenotypically. They can be divided into four phenotypes, namely intestinal, gastric, gastrointestinal and null types. Present findings show that well-differentiated gastric adenocarcinoma in the WHO classification is highly consistent with intestinal type gastric cancer in the Lauren classification. Expression of phenotypic marker is of certain clinic-pathologic significance.
