Lim Sung-Chul
Department of Pathology, College of Medicine Chosun University, Kwangju, Korea.
Oncol Rep. 2002 Jan-Feb;9(1):103-7.
This study was undertaken to determine whether human gastric adenocarcinoma expresses Fas-L, and whether serum sFas-L level changes in patients before and after gastrectomy, and whether Fas-L or sFas-L is related to tumor stage and histologic type. Retroactive analysis was performed in 38 cases of early gastric carcinoma (EGC) and 61 cases of advanced gastric carcinoma (AGC), including 38 cases of diffuse type and 61 cases of intestinal type, who underwent gastric resection from 1997 to 1998. Immunohistochemical staining for tumoral Fas-L detection and a sFas ligand ELISA kit for serum sFas-L detection were used. Fas-L was localized in neoplastic cells in 61% (23/38) of cases in the EGC group and 66% (40/61) of cases in the AGC group. The extent of Fas-L expression was variable, with both FasL-positive and -negative neoplastic regions occurring within a tumor. The mean serum sFas-L level was significantly higher in patients before treatment compared with that of controls, whereas the level in patients after gastrectomy was significantly lower as that of controls. Some patients whose preoperative serum sFas-L levels were within the normal limit expressed no tumoral Fas-L. Factors such as tumor stage, histologic subtype and other prognostic factors showed no correlation with Fas-L expression and serum sFas-L level. A statistically significant expression of tumoral Fas-L with concomitant increment of serum sFas-L in gastric adenocarcinoma was demonstrated. This finding suggested Fas-mediated apoptosis in response to Fas-L expression by gastric adenocarcinoma, providing evidence to support a Fas counterattack and indicated that the serum sFas-L level is a useful indicator in evaluating preoperative diagnosis and postoperative follow-up of gastric adenocarcinoma. The clinical stages of gastric adenocarcinoma of the intestinal and the diffuse type did not differ in their expression of Fas and sFas-L.
本研究旨在确定人胃腺癌是否表达Fas-L，胃切除术前、后患者血清sFas-L水平是否发生变化，以及Fas-L或sFas-L是否与肿瘤分期和组织学类型相关。对1997年至1998年接受胃切除术的38例早期胃癌（EGC）和61例进展期胃癌（AGC）进行回顾性分析，其中包括38例弥漫型和61例肠型。采用免疫组织化学染色检测肿瘤Fas-L以及用sFas配体ELISA试剂盒检测血清sFas-L。Fas-L定位于EGC组61%（23/38）的病例和AGC组66%（40/61）的病例的肿瘤细胞中。Fas-L表达程度各不相同，肿瘤内同时存在FasL阳性和阴性区域。治疗前患者的血清sFas-L平均水平显著高于对照组，而胃切除术后患者的水平显著低于对照组。一些术前血清sFas-L水平在正常范围内的患者未表达肿瘤Fas-L。肿瘤分期、组织学亚型和其他预后因素等与Fas-L表达和血清sFas-L水平均无相关性。胃腺癌中肿瘤Fas-L有统计学意义的表达并伴有血清sFas-L升高。这一发现提示胃腺癌对Fas-L表达产生Fas介导的凋亡，为支持Fas反击提供了证据，并表明血清sFas-L水平是评估胃腺癌术前诊断和术后随访的有用指标。肠型和弥漫型胃腺癌的临床分期在Fas和sFas-L表达方面无差异。
