Kozuki T, Yao T, Nakamura S, Matsumoto T, Tsuneyoshi M
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Histopathology. 2002 Jul;41(1):56-64. doi: 10.1046/j.1365-2559.2002.01407.x.
The aim of this study was to elucidate possible clinicopathological differences between diffusely infiltrating gastric carcinoma of 'pure type' (poorly differentiated carcinoma without any glandular component) and 'mixed type' (coexistence of poorly differentiated carcinoma and intramucosal glandular component).
The clinicopathological features and immunohistochemical expression of p53 and intercellular adhesion molecules (E-cadherin and alpha-, beta- and gamma-catenins) were compared between the patients with pure (n=59) and mixed (n=56) types of diffusely infiltrating gastric carcinoma. Intestinal metaplasia (P < 0.01), prominent lymphatic permeation (P < 0.001) and lymph node metastasis (P < 0.05) were more frequently observed in mixed type than in pure type, while survival probability did not differ between the two groups. The frequency of p53 over-expression was higher in mixed type (56%) than in pure-type (19%) (P < 0.001). In mixed type, p53 expression was not different between glandular and poorly differentiated components. By contrast, the expression of adhesion molecules was more frequently preserved in glandular components than in poorly differentiated components.
These two subtypes seem to be different in nature and biological behaviour. The preservation of adhesion molecules in mixed type may be associated with higher incidence of lymphatic permeation and lymph node metastasis.
本研究旨在阐明“纯型”(无任何腺性成分的低分化癌)与“混合型”(低分化癌与黏膜内腺性成分并存)弥漫浸润性胃癌之间可能存在的临床病理差异。
比较了59例“纯型”和56例“混合型”弥漫浸润性胃癌患者的临床病理特征以及p53和细胞间黏附分子(E-钙黏蛋白、α-、β-和γ-连环蛋白)的免疫组化表达。与纯型相比,混合型中肠化生(P<0.01)、显著的淋巴管浸润(P<0.001)和淋巴结转移(P<0.05)更为常见,而两组的生存概率无差异。p53过表达的频率在混合型(56%)高于纯型(19%)(P<0.001)。在混合型中,腺性成分和低分化成分的p53表达无差异。相比之下,黏附分子的表达在腺性成分中比在低分化成分中更常保留。
这两种亚型在本质和生物学行为上似乎有所不同。混合型中黏附分子的保留可能与淋巴管浸润和淋巴结转移的较高发生率有关。