CD44v6与可溶性CD44v6在胃癌中的表达及与预后的关系

目的 探讨CD44v6与可溶性CD44v6(sCD44v6)在胃癌中的表达及与胃癌生物学行为和预后的关系.方法 应用免疫组化S-P法检测103例胃癌组织和10例正常胃黏膜标本的CD44v6表达,并对患者进行术后随访,随访期为3～91个月;应用酶联免疫吸附(ELISA)法检测86例胃癌、30例胃溃疡患者和30例健康人外周血血清中sCD44v6的浓度,并对患者进行术后随访,随访期为1～91个月.结果 (1)CD44v6在正常胃黏膜中不表达,而在胃癌中的表达率为60.2%;CD44v6的表达与淋巴结转移、TNM分期、脉管是否存在癌栓以及Borrmann分型有关(P＜0.05),而与胃癌浸润深度、是否远处转移、分化程度以及患者的生存率无关(P＞0.05);9例伴有肝转移的胃癌患者中,有7例CD44v6为强阳性表达.(2)胃癌患者外周血血清中sCD44v6的浓度明显高于胃溃疡组和健康对照组(P＜0.01);胃癌根治术后患者血液中sCD44v6的浓度比术前明显下降(P＜0.01),而姑息术后患者的浓度变化却不明显(P＞0.05);sCD44v6的浓度与胃癌浸润深度、淋巴结转移、是否远处转移、脉管是否存在癌栓、Borrmann分型以及分化程度无关;sCD44v6浓度较高组的生存率较sCD44v6浓度较低组高,且差异有统计学意义(P=0.0281),但经Cox回归分析显示,sCD44v6的浓度与生存期有关(P=0.415),而手术方式却与生存期有关(P=0.000).(3)胃癌组织中CD44v6的表达与外周血血清中sCD44v6的表达无明显平行关系(P＞0.05).结论 CD44v6的表达对评估胃癌生物学行为有参考价值,但是否与预后有关仍需探讨;sCD44v6的表达对胃癌辅助诊断、手术彻底性判定及生物学行为评估有一定的意义;CD44v6与sCD44v6的表达无明显平行关系.

Expression and clinical significance of CD44v6 and sCD44v6 in gastric carcinoma

OBJECTIVE: To evaluate the correlation of CD44v6 and sCD44v6 expression with the biological activity of gastric carcinoma. METHODS: Mucosa samples from 103 gastric carcinoma patients and 10 healthy persons (control) were examined using immunohistochemical SP method; sCD44v6 level in peripheral blood samples was detected with ELISA in 86 gastric cancer patients, 30 gastric ulcer patients and 30 healthy controls. The follow-up period was 3-91 months for 88 patients in CD44v6 group and 1-91 months for 55 patients in sCD44v6 group. RESULTS: (1) Positive expression of CD44v6 was found in 60.2% of gastric carcinoma, where as 0% in the normal gastric mucosa. CD44v6 protein expression was positively correlated with TNM stage, perigastric lymph node metastasis, presence of cancerous embolic angiopathy and Borrmann classification (P <0.05), but was not correlated with invasion depth, differentiation, metastasis and survival (P > 0.05); 77.8% of the patient with liver metastasis had a strong CD44v6 protein expression. (2) sCD44v6 level in the peripheral blood of gastric carcinoma patient was significantly higher than that in gastric ulcer patient or healthy control; Compared with palliative gastrectomy, sCD44v6 level significantly went down after radical operation. No relationship between sCD44v6 level and the pathological features was found, which included invasion depth, perigastric lymph node metastasis, presence of cancerous embolic angiopathy, differentiation and Borrmann classification; The survival in the high sCD44v6 level group was longer than that in low sCD44v6 level group ( P = 0.0281), but no significant difference was observed by Cox Regression analysis (P = 0.415). (3) No apparent correlation was observed between CD44v6 expression in gastric cancer and sCD44v6 concentration in peripheral blood (P>0.05). CONCLUSION: Detection of CD44v6 expression in the gastric cancer may be helpful in evaluating the biological features and the survival in gastric carcinoma. The level of sCD44v6 in the blood may be also helpful in differential diagnosis, evaluation of surgical treatment and biological activity for gastric cancer. No apparent correlation is observed between CD44v6 expression in the cancer and that of sCD44v6 in the blood.