Ikeguchi M, Cai J, Yamane N, Maeta M, Kaibara N
Department of Surgery I, Faculty of Medicine, Totori University, Yonago, Japan.
Cancer. 1999 Jun 1;85(11):2329-35.
Spontaneous apoptosis has been detected in gastric carcinoma. However, the clinicopathological significance of this remains unclear. The objective of this study was to investigate the correlation between spontaneous apoptosis and the clinicopathologic and biologic characteristics of advanced gastric carcinoma. In addition, the prognostic significance of spontaneous apoptosis of tumors was evaluated.
The occurrence of apoptotic cell death (apoptotic index [AI]) in 97 patients with advanced gastric carcinoma was analyzed by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate biotin nick end labeling method. The Ki-67 labeling index (LI), expression of p53 and p21, DNA ploidy pattern, microvessel density (MVD), density of dendritic cells (DCs) in tumors, and degree of lymphocytic infiltration (LI) of the tumors were compared with the AI for each patient. In addition, the prognostic significance of AI was evaluated in these patients.
The mean AI of the 97 tumors was 2.05% (range, 0-11.31%). Statistical analyses revealed significant correlations between the AIs and the Ki-67 LIs (P = 0.0004) and between the AIs and the density of DCs (P = 0.0007), as well as an inverse correlation between the AIs and the intratumoral MVD (P = 0.0064). In addition, the AI of 47 tumors with high grade LI (2.94+/-2.51%) was significantly higher than that of 50 tumors with low grade LI (1.22+/-0.93%) (P<0.0001). However, the authors failed to find a significant correlation between the AIs and expression of p53 and p21 and the DNA ploidy pattern. In 93 surviving patients, the 5-year survival rate of 45 patients who had tumors with high AIs (> or =1.47; 82%) was significantly better than that of 48 patients who had tumors with low AIs (<1.47; 60%) (P = 0.0264).
The findings of the current study suggest that the tumors with low neovascularization and high local immunoreactivity may regulate their progression by apoptosis. Moreover, less extensive apoptosis in gastric adenocarcinoma may contribute to disease progression and could be correlated with a poorer prognosis.
胃癌中已检测到自发凋亡。然而，其临床病理意义仍不清楚。本研究的目的是探讨晚期胃癌自发凋亡与临床病理及生物学特征之间的相关性。此外，还评估了肿瘤自发凋亡的预后意义。
采用末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸生物素缺口末端标记法分析97例晚期胃癌患者凋亡细胞死亡的发生率（凋亡指数[AI]）。将每位患者的Ki-67标记指数（LI）、p53和p21的表达、DNA倍体模式、微血管密度（MVD）、肿瘤中树突状细胞（DC）密度以及肿瘤的淋巴细胞浸润程度（LI）与AI进行比较。此外，还评估了AI在这些患者中的预后意义。
97个肿瘤的平均AI为2.05%（范围为0 - 11.31%）。统计分析显示，AI与Ki-67 LI之间存在显著相关性（P = 0.0004），AI与DC密度之间存在显著相关性（P = 0.0007），且AI与肿瘤内MVD之间存在负相关（P = 0.0064）。此外，47例高等级LI肿瘤的AI（2.94±2.51%）显著高于50例低等级LI肿瘤的AI（1.22±0.93%）（P<0.0001）。然而，作者未发现AI与p53和p21的表达以及DNA倍体模式之间存在显著相关性。在93例存活患者中，45例AI高（≥1.47；82%）的患者的5年生存率显著高于48例AI低（<1.47；60%）的患者（P = 0.0264）。
本研究结果表明，新生血管形成少且局部免疫反应高的肿瘤可能通过凋亡来调节其进展。此外，胃腺癌中凋亡程度较低可能促进疾病进展，并可能与较差的预后相关。
