胃癌及淋巴结转移灶中CD44v6和上皮钙粘素的表达及其意义

目的 :探讨 CD4 4 v6和上皮钙粘素 (E- cd)在胃腺癌及淋巴结转移灶中的表达及其意义。方法 :应用免疫组化 SABC法检测 2 0例正常胃粘膜 ,2 0例异形增生 ,185例胃癌原发灶及 10 9例淋巴结转移灶中 CD4 4 v6和 E- cd表达。结果 :CD4 4 v6和 E- cd在异型增生、胃癌原发灶及淋巴结转移灶中阳性表达率分别为 2 0 .0 0 % (4/ 2 0 )、66.4 9% (12 3 / 185 )和87.18% (10 2 / 10 8)以及 85 .0 0 % (17/ 2 0 )、5 2 .97% (98/ 185 )和 2 6.5 0 % (3 1/ 117)。三者之间有显著差异 (P<0 .0 1)。CD4 4 v6表达率与胃癌生长方式、组织学类型、血管淋巴管内浸润及 TNM分期无关。 E- cd阳性表达与胃癌生长方式、组织学类型及 TNM分期显著相关。早期肠型胃癌 CD4 4 v6阳性表达率显著高于弥漫型 (P<0 .0 5 ) ,在进展期胃癌则无显著差异。E- cd的阳性表达率下降主要见于弥漫型胃癌。结论 :CD4 4 v6和 E- cd阳性表达同胃癌分化及生物学行为密切相关 ,是预测其侵袭转移有价值的指标。同时 ,此结果也支持胃癌两种不同起源的假说。

Significance and Expression of CD44v6 and E-cadherin in Gastric Carcinomas and Their Lymph-node Metastases

Purpose: To study significance and expression of CD44v6 and E cd in gastric carcinomas and their lymph node metastases. Methods: Immunohistochemical method was used to detect CD44v6 and E cd expression in 20 normal gastric mucosa tissues, 20 gastric epithelial dysplasia, 185 gastric adenocarcinomas and 109 metastatic lymph nodes. Results: The positive expression rates of CD44v6 and E cd in gastric epithelial dysplasia, gastric adenocarcinomas and their 1ymph node metastases were 20.00%(4/20), 66.49%(123/185) and 87.18%(102/118) 85.00%(17/20), 52.97(98/185) and 26.50%(31/117) respectively with significant difference (P<0.01). The positive expression of CD44v6 was not closely correlated with differentiation, with TNM categories, with lymph node involvement, and with blood and lymphatic vessel invasion. CD44v6 was closely related to intestional type early gastric carcinomas. The expression of E cd were closely linked to diffuse typt gastric carcinomas. Conclusion: CD44v6 and E cd might be valuable markers in assessing biological behavior, invasion and metastatic potential of gastric carcinomas. The results also support the theory of different origins for the two tumor types.