Prognostic use of growth characteristics of early gastric cancer and expression patterns of apoptotic, cell proliferation, and cell adhesion proteins
Prognostic use of growth characteristics of early gastric cancer and expression patterns of apoptotic, cell proliferation, and cell adhesion proteins
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DOI：
10.1002/jso.10204
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发表时间：
2003-02-01
影响因子：
2.5
通讯作者：
Gobe, G
中科院分区：
文献类型：
--
作者：
Pan, WS;Ishii, H;Gobe, G
背景和目标：通过比较癌症的生长特征与选定的分子特征，可以帮助选择早期胃癌的合适治疗，例如内镜粘膜切除术或癌症切除术与根治性淋巴结清扫术的主要手术选择。该结果可用于预测那些具有较高发生继发转移风险的病例。研究方法：共有1，196例日本早期胃癌患者（648例粘膜癌和548例粘膜下癌）被纳入两组选择中：转移组由57例伴有淋巴结转移的癌症（9例粘膜癌，48例粘膜下癌）组成，非转移组由61例无淋巴结转移的病例（6例粘膜癌，55例粘膜下癌）组成。肿瘤的生长特征（表面扩散、穿透或侵袭、淋巴结转移）与单链DNA（ssDNA）蛋白（凋亡指示剂）、bcl-2和p53（凋亡相关）、Ki-67（细胞增殖）和E-钙粘蛋白（细胞粘附）蛋白的免疫组化表达进行比较。结果如下：与转移组相比，非转移组的病变具有较高的凋亡水平和较低的bcl-2表达，表明凋亡在恶性进展中的抑制作用。两组浅表病变的细胞凋亡率均高于浸润性病变。转移组p53蛋白表达高于非转移组，而细胞凋亡低于非转移组。一个未经证实的解释，这一发现可能是，虽然增加，p53突变和无效的促进细胞凋亡控制转移进展。E-钙粘蛋白在两组的浸润性病变中均降低，表明这些细胞失去粘附、侵入粘膜下层和转移的能力更强。转移组和非转移组的浅表病变中细胞增殖最高。结论：早期胃癌细胞凋亡水平低、bcl-2表达增加、p53表达水平高，更容易侵袭和转移。(C)2003 Wiley-Liss，Inc.
Background and Objectives: Selection of suitable treatment for early gastric cancers, such as endoscopic mucosal resection or the major surgical option of resection of the cancer together with a radical lymph node dissection, may be assisted by comparing the growth characteristics of the cancer with selected molecular characteristics. The results could be used to predict those cases that have a higher risk of developing secondary metastases. Methods: A total of 1,196 Japanese patients with early gastric cancers (648 mucosal cancers and 548 submucosal) were included in the selection of two groups: a metastatic group made up 57 cancers with lymph node metastasis (9 mucosal, 48 submucosal), and a nonmetastatic group of 61 cases (6 mucosal, 55 submucosal) without lymph node metastasis. Growth characteristics of the cancers (superficially spreading, penetrating or invasive, lymph node metastasis) were compared with immunohistochemical expression of single-stranded DNA (ssDNA) protein (apoptosis indicator), bcl-2 and p53 (apoptosis-associated), Ki-67 (cell proliferation), and E-cadherin (cell adhesion) proteins. Results: The lesions in the nonmetastatic group had higher levels of apoptosis and lower expression of bcl-2 than in the metastatic group, indicating an inhibitory role for apoptosis in malignant progression. Apoptosis was also higher in the superficial compared with the invasive lesions of both groups. The lesions in the metastatic group had higher p53 expression than that of the nonmetastatic group, whereas apoptosis in the metastatic group was lower than in the nonmetastatic group. An unproved explanation for this finding may be that, although increased, p53 was mutated and ineffective in promoting apoptotic control of metastatic progression. E-cadherin was decreased in the invasive lesions of both groups, indicating a greater ability of these cells to lose adhesion, to invade the submucosa, and to metastasize. Cell proliferation was highest in the superficial lesions of both metastatic and nonmetastatic groups. Conclusions: Early gastric cancers with low levels of apoptosis, increased bcl-2, and high levels of p53 expression are more likely to invade and metastasize. (C) 2003 Wiley-Liss, Inc.