胃癌组织HLA－I类和DR分子免疫组化研究

本文应用免疫组化法对６４例胃癌、癌旁组织和６例胃溃疡大致正常胃粘膜冰冻和石蜡切片进行了染色．结果表明，正常胃粘膜和癌旁胃粘膜上皮细胞ＨＬＡ－Ｉ类分子表达阳性，其着色较均一，ＨＬＡ－ＤＲ染色均阴性．胃癌细胞Ｉ类分子表达缺失（２７／６４例），与癌旁上皮比较差异显著（Ｐ＜０．０１）。粘液细胞癌和低分化癌Ｉ类分子缺失率显著高于高分化癌（Ｐ＜０．０２５）．此外，发生肿瘤转移的病例Ｉ类分子缺失率（１２／１５例）显著高于无转移组（１／５例，Ｐ＜０．０２５）．ＤＲ分子在癌组织表达阳性，其阳性率高达５３．１％（３４／６４例）．低分化癌ＤＲ分子阳性率亦显著高于高分化癌和中分化癌，未分化癌ＤＲ分子阳性率亦显著高于高分化癌（Ｐ＜０．０１～０．０５）．提示（１）ＨＬＡ－Ｉ类分子表达缺失可能与癌细胞逃避宿主免疫监视发生润浸生长和转移有关；（２）分化程度不同的癌组织ＨＬＡ－Ｉ类分子表达差异显著，提示癌细胞分化可能影响Ｉ、Ⅱ类分子表达和肿癌抗原呈递；（３）ＨＬＡ－Ｉ类和ＤＲ分子表达异常可能是上皮恶性转变的标志之一．

Expression of HLA class I and HLA-DR antigens in gastric carcinoma and adjacent tissues

The expression of HLA class 1 and HLA DR monomorphic determinant antigens were analysed in tumor and the adjacrnt tissues from 64 cases of gastric carcinoma, and normal gastric mucosa from 6 patients with gastric ulcer. The results showed that the expression of HLA class I molecule was positive in normal gastric mucosa and the adjacent tissues of cancer, but no expression of HLA-DR antigen in these tissues. 27 of 64 gastric carcinomas were found completely (4. 7%) or partially (37.5%) lack of HLA class I molecule, which seemed to correlate with the degree of de-differentiation of the cancer cells. Loss of HLA class I molecule in the subjects with metastasis (80%) was more significant than that in the non-metastasizing tumors (20%) (p<0.05). HLA-DR antigens were found to be expressed on cancer cells, with a positive rate as 53. 19%(34/64 cases). Expression of HLA-DR antigen in carcinous tissues was associated with the degree of cell differentiation. It was suggested that: (1) tumor cells lacking class I antigen might be those which could escape the host immune surveillance and result in invasive growth and metastases, (2) expression of HLA class I and HLA-DR antigens was significantly different in the tumors with different differentiation. So the differentiation of tumors might influence the expression of HLA antigens and the presentation of tumor antigen, (3) abnormal expression of HLA class I and DR molecule on tumors might be considered as new markers of malignant trans formation.