TUMOR BASEMENT-MEMBRANE LAMININ IN ADENOCARCINOMA OF RECTUM - AN IMMUNOHISTOCHEMICAL STUDY OF BIOLOGICAL AND CLINICAL-SIGNIFICANCE
TUMOR BASEMENT-MEMBRANE LAMININ IN ADENOCARCINOMA OF RECTUM - AN IMMUNOHISTOCHEMICAL STUDY OF BIOLOGICAL AND CLINICAL-SIGNIFICANCE
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DOI：
10.1002/ijc.2910370603
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发表时间：
1986-06-15
影响因子：
6.4
通讯作者：
CRITCHLEY, DR
中科院分区：
文献类型：
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作者：
FORSTER, SJ;TALBOT, IC;CRITCHLEY, DR
免疫组织化学染色显示，158例直肠腺癌中，98例(62%)基底膜层粘连蛋白表达清晰。层粘连蛋白阳性肿瘤患者中只有27例(28%)发生远处转移，而层粘连蛋白阴性肿瘤患者中有39例(65%)发生远处转移。层粘连蛋白阳性和阴性肿瘤患者的校正5年生存率分别为65%和23%。30例高分化腺癌中25例(83%)表达基底膜层粘连蛋白，而15例低分化腺癌中仅3例(17%)表达基底膜层粘连蛋白，中分化腺癌呈中等层粘连蛋白状态(70/110，%，层粘连蛋白阳性)。在60例层粘连蛋白阴性的肿瘤中，43例(72%)有区域淋巴结转移。这些数据表明，层粘连蛋白可能是分化的标志。然而，层粘连蛋白的状态提供了关于肿瘤行为的信息，而不限于分期和分级，多变量分析表明，它是比传统组织学评估的肿瘤分级更好的预后指标。尽管层粘连蛋白状态本身对预后的预测不如Dukes分期有用，但直肠层粘连蛋白阳性的直肠腺癌患者的5年生存率是层粘连蛋白阴性肿瘤患者的2.7倍。因此，层粘连蛋白状态的评估和Dukes‘分期被认为是比组织学分化程度更准确和客观的结直肠癌预后指标。
Well-defined basement membrane laminin was seen in 98/158 (62%) rectal adenocarcinomas stained by an immunoperoxidase method. Only 27 (28%) patients with laminin-positive tumors developed distant metastases, compared with 39 (65%) patients with laminin-negative carcinomas. The corrected 5-year survival rates for patients with laminin-positive and laminin-negative tumors were 65% and 23%, respectively. Twenty-five out of 30 (83%) well-differentiated adenocarcinomas and only 3/15 (17%) poorly differentiated tumors contained basement membrane laminin, with moderately differentiated carcinomas showing intermediate laminin status (70/110, 64%, laminin positive). Forty-three of 60 (72%) of laminin-negative tumors had metastasized to regional lymph nodes. These data suggest that laminin may be a marker for differentiation. However, laminin status yields information about tumor behavior which is not confined to stage and grade, and multivariate analysis shows that it is a better indicator of prognosis than tumor grade as assessed by conventional histology. Although laminin status alone is a less useful predictor of prognosis than Dukes'' stage, a patient with a laminin-positive adenocarcinoma of rectum is 2.7 times as likely to survive 5 years than a patient with a laminin-negative tumor. Assessment of laminin status, together with Dukes'' stage is, therefore, commended as a more precise and objective indicator of prognosis than histological degree of differentiation in colorectal carcinoma.