CD44蛋白在胃癌中的表达及与临床关系的探讨

目的:探讨CD44蛋白在胃癌中表达及与临床的关系。方法:采用免疫组化S-P方法检测CD44S及CD44变异体V6在54例胃良性病变(BGD)及63例胃癌(GC)中的表达,并比较了阳性表达与肿瘤组织分型及临床预后等相关性。结果:CD44S在浅表性胃炎(CSG)、萎缩性胃炎伴肠上皮化生(CAG/IM)及GC中表达阳性率分别为48.5％、57.1％和52.4％。CD44V6在CSG中无表达,在CAG/IM及GC中表达阳性率为19.1％和53.9％。在肠型胃癌中,CD44V6表达率(73.7％)明显高于弥漫型胃癌(24％)。CD44S阳性表达与组织分型无关。CD44S阳性表达与术后复发率呈正相关,与5年生存率呈负相关。结论:CD44S和CD44V6在胃癌中均有表达,CD44V6表达率与胃癌组织来源有关。CD44S表达率与临床预后有关。

The Expression of CD44 protein in Gastric Cancer and its Clinical Correlation

Background/Aims: CD44 is a cell surface adhesion molecule involved in cell-cell and cell-matrix interactions. Tumor cells transfected to overexpress the isoform CD44V readily gain access to lymph nodes and form distant metestasis. Methods: The streptavidin/peroxidase immunohistochemical method was performed to study the expression of the variant forms of standard (CD44S) and its variant (CD44V6), in which 63 subjects with gastric carcinoma were dealt with in comparison with 54 cases with benign diseases of stomach as control (CSG 33, CAG/IM21). Results: (1) the positive expression of CD44S in CSG, CAG/IM and GC was 48.5%, 57.1% and 52.4% without statistical significance (P>0.05) versus CD44V6 of 0%, 19.1% and 53.9% respectively with apparent significance (P<0.05). (2) The expression of CD44V6 in intestinal and diffused type of gastric carcinoma was 73.7% and 24% with significance (P<0.05). (3) The results of a follw-up of 6 to 70 months among 30 patients undertaken showed that recurrence of those with positive CD44 expression was 68.4% in comparison with 27.2% with negative CD44 expression. The 5-year survival rate was 31.6% and 72.7% respectively. Conclusion: Generation of CD44 and its splice variants may be closely linked with gastric carcinoma tumorigenesis and differentiation. In addition, expression of CD44S related to recurrence and mortality of tumor.