Loss of standard type of CD44 expression in invaded area as a good indicator of lymph-node metastasis in colorectal carcinoma
Loss of standard type of CD44 expression in invaded area as a good indicator of lymph-node metastasis in colorectal carcinoma
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DOI：
10.1007/bf02237430
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发表时间：
2000-09-01
影响因子：
3.9
通讯作者：
Kuwano, H
中科院分区：
文献类型：
--
作者：
Asao, T;Nakamura, J;Kuwano, H
目的：最近的进展使通过息肉切除术或内镜粘膜切除术治疗小浸润性结直肠癌成为可能。CD 44在癌细胞中的表达被确定为淋巴结转移的指标，这可以在结肠镜切除的标本中进行评估。方法：采用免疫组织化学方法检测61例浅表浸润性结直肠癌组织中浸润癌细胞的淋巴结转移与癌细胞标准型CD 44表达的相关性。我们将上述定义为局限于结直肠壁内的浸润性癌。在61例标本中，31例有粘膜下浸润，30例有肌层浸润。结果：淋巴结转移组浸润区标准型CD 44表达明显下调。43例无淋巴结转移者中36例（83.7%）浸润细胞表达CD 44，而18例有淋巴结转移者中仅有2例（11.1%）浸润细胞表达标准型CD 44（P < 0.0001）。69.6%（16/23）浸润部位标准型CD 44表达缺失的患者发现淋巴结转移阳性。这些结果表明，标准型CD 44在侵袭性结肠癌细胞中可以抑制向区域淋巴结的转移。结论：在浸润性结直肠癌的情况下，标准型CD 44表达在浸润区域的丢失是淋巴结转移的敏感标志物。需要对更大的患者群体进行进一步研究，以阐明标准型CD 44表达缺失作为粘膜下浸润性结直肠癌内镜切除术后额外手术的指标的可靠性。
PURPOSE: Recent advances have made possible the treatment of small invasive colorectal cancer by means of polypectomy or endoscopic mucosal resection. CD44 expression in cancer cells was identified as an indicator of lymph-node metastasis, which could be evaluated in specimens removed by colonoscopy. METHODS: The correlation between lymph-node metastasis and the expression of standard-type CD44 in cancer cells was examined immunohistologically using the invaded cancer cells of 61 tissue samples of superficially invasive colorectal cancer. We defined the above as invasive cancer restricted within the colorectal wall. Of the 61 samples, 31 had submucosal invasion and 30 had muscular invasion. RESULTS: Standard-type CD44 expression in the area of invasion in cases with lymph-node metastasis was remarkably down-regulated. In 43 cases with no lymph-node metastasis, 36 (83.7 percent) of patients had CD44 expression in invaded cells, whereas only two of 18 cases (11.1 percent) with lymph-node metastasis had expression of standard-type CD44 in the same area (P < 0.0001). A total of 69.6 percent (16/23) of patients with loss of standard-type CD44 expression in invaded sites were found to have positive metastasis in the lymph nodes. These results suggest that standard-type CD44 in invasive colon cancer cells could suppress metastasis to the regional lymph nodes. CONCLUSION: In cases of invasive colorectal cancer, the loss of standard-type CD44 expression in the invaded area is a sensitive marker for metastasis to the lymph nodes. Further investigation with larger patient groups is required to clarify the reliability of loss of standard-type CD44 expression as an indicator for additional surgery after endoscopic resection of submucosal invasive colorectal carcinoma.