胃癌及癌前病变组织中CD44v6表达的意义

目的探讨CD44v6基因表达与胃癌发生及胃癌生物学行为的关系.方法应用抗CD44v6蛋白的单克隆抗体,采用免疫组化ABC方法对正常胃粘膜(n=10)、各级胃粘膜异型增生(轻度n=16,中度n=12,重度n=14)、早期胃癌(n=16)及进展期胃癌(n=52)进行研究,并与胃癌类型、大小、有无淋巴结转移等作了比较分析.结果正常胃粘膜CD44v6为阴性,随着胃粘膜病变的进展,CD44v6蛋白的表达率逐渐升高,至进展期胃癌,表达率达到顶峰.轻、中、重度异型增生表达率分别为12%,33%,43%;早期胃癌及进展期胃癌的表达率分别为44%和73%.各级异型增生表达率之间的差异无显著性,而进展期胃癌表达率显著高于早期胃癌(P＜0.05),淋巴结转移组的表达率显著高于淋巴结未转移组(82%vs56%,P＜0.05),肠型胃癌的表达率高于弥漫型胃癌(78%vs56%,P＜0.05),CD44v6蛋白的表达与胃癌肿块大小无相关性.结论胃粘膜重度异型增生在CD44v6基因表达上已具有明显的潜在恶性趋势,CD44v6基因表达阳性的胃癌具有更强的浸润及淋巴结转移的能力.

Significance of CD44v6 protein expression in gastric carcinoma and precancerous lesions

AIM To study the relationship between CD44V6 protein expression and gastric carcinogenesis and behavior of gastric carcinoma.METHODS Ten normal gastric mucosas, 43 gastric mucosal dysplasias (including 16 slight, 12 moderate and 14 severe dysplasias), 16 early gastric carcinomas and 52 advanced gastric carcinomas were marked with the monoclonal antibody to CD44v6 protein by using immunohistochemica! ABC method. The relationship between CD44v6 protein expression the histological type, size and lymph node metastasis of gastric carcinoma was analysed.RESULTS Normal gastric mucosa was negative for CD44v6 protein. The positive rates in dysplasia and gastric carcinoma increased gradually with the progression of lesions. The positive rates were 12%, 33% and 43% in slight, moderate and severe dysplasias respectively, and was 44% in early gastric carcinoma and 74% in advanced gastric carcinoma. The positive rate in advanced gastric carcinoma was significantly higher than that in early gastric carcinoma (P<0.05), and the positive rate of the group with lymph node metastasis was significantly higher than that of the group without lymph node metastasis (82% vs 56%, P<0.05). In histological types classified by Laurens, the positive rate of intestinal-type gastric carcinoma was significantly higher than that of diffuse-type gastric carcinoma (78% vs 56%, (P<0.05), but the expression of CD44v6 protein was not correlated to the size of gastric carcinoma.CONCLUSION Gene expression of severe gastric mucosal dysplasia has an obviously latent malignant tendency and gastric carcinoma with the expression of CD44v6 protein has a stronger ability of infiltration and lymph node metastasis.