LI-cadherin:: a marker of gastric metaplasia and neoplasia
LI-cadherin:: a marker of gastric metaplasia and neoplasia
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DOI：
10.1136/gut.49.1.73
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发表时间：
2001-07-01
期刊：
影响因子：
24.5
通讯作者：
Gessner, R
中科院分区：
文献类型：
--
作者：
Grötzinger, C;Kneifel, J;Gessner, R
背景：肠上皮化生被认为是肠型胃腺癌发生的危险因素，约20%的胃活检发现肠上皮化生。常规组织学只检测晚期肠化生。目的：研究肠细胞特异性黏附分子肝肠粘连蛋白（LI -cadherin）在肠化生和胃癌中的表达，并评价其作为诊断标志物的应用价值。患者：分析30例连续患者（30例，年龄28-90岁）的胃活检（n=77）以及所有类型胃癌的手术切除组织样本（n=24）。方法：对胃活检组织冷冻切片进行单、双标记免疫荧光检测；石蜡包埋癌组织切片碱性磷酸酶抗碱性磷酸酶法。结果：来自30例患者的77例活检中，12例（来自10例患者）LI-cadherin染色阳性。LI-cadherin染色与肠化生的存在相关。然而，常规组织学诊断未能发现细微的胃肠道化生（10例中有3例）。相比之下，只有LI-cadherin和villin在这些病例中呈阳性，而蔗糖-异麦芽糖酶在10例患者中也未能检测到肠化生。高分化胃癌LI-cadherin染色强烈，未分化胃癌LI-cadherin染色微弱。结论- li -钙粘蛋白检测胃黏膜早期化生变化的敏感性优于蔗糖酶-异麦芽糖酶和常规组织学检查，与绒毛蛋白相当。其特异性超过绒毛蛋白。因此，li -钙粘蛋白是一种新的、可靠的、强有力的早期检测胃肠化生和高分化腺癌的标志物分子。
Background-Intestinal metaplasia is considered a risk factor for the development of gastric adenocarcinomas of the intestinal type and is found in approximately 20% of gastric biopsies. Conventional histology only detects advanced stages of intestinal metaplasia.Aims-To study expression of the enterocyte specific adhesion molecule liver-intestinal (LI)-cadherin in intestinal metaplasia as well as in gastric cancer, and to evaluate its use as a diagnostic marker molecule.Patients-Gastric biopsies (n=77) from 30 consecutive patients (n=30; aged 28-90 years) as well as surgically resected tissue samples (n=24) of all types of gastric carcinomas were analysed.Methods-Single and double label immunofluorescence detection on cryosections of gastric biopsies; alkaline phosphatase antialkaline phosphatase method on paraffin embedded carcinoma tissue sections.Results-Of 77 biopsies (from 30 patients), 12 (from 10 patients) stained positive for LI-cadherin. LI-cadherin staining correlated with the presence of intestinal metaplasia. Conventional histological diagnosis however failed to detect subtle gastric intestinal metaplasia (three of 10 patients). In contrast, only LI-cadherin and villin were positive in these cases whereas sucrase-isomaltase also failed to detect intestinal metaplasia in four of 10 patients. Well differentiated gastric carcinomas showed intense staining for LI-cadherin while undifferentiated carcinomas showed only weak diffuse cytoplasmic staining.Conclusions-To detect early metaplastic changes in the gastric mucosa, LI-cadherin has a sensitivity superior to sucrase-isomaltase and conventional histology and comparable with that of villin. Its specificity exceeds that of villin. Thus LI-cadherin represents a new, reliable, and powerful marker molecule for early detection of gastric intestinal metaplasia and well differentiated adenocarcinomas.