Chang Hee Jin, Kim Sun Whe, Lee Byung Lan, Hong Eun Kyung, Kim Woo Ho
Department of Pathology, National Cancer Center, Seoul National University College of Medicine, Seoul, Korea.
Pathol Int. 2004 Aug;54(8):576-84. doi: 10.1111/j.1440-1827.2004.01666.x.
In order to evaluate the significance of altered expression of mucin and cytokeratin during gallbladder carcinogenesis, we characterized the expressional profiles of MUC1, MUC2, MUC5AC, MUC6, CK7 and CK20 in 33 normal mucosa, 31 adenomas, 55 dysplasias and 131 carcinomas of the gallbladder. In normal gallbladder mucosa, the expressions of MUC5AC and MUC6 were diffuse and MUC1 expression was absent. However, in adenomas, dysplasias and carcinomas, the expressions of MUC5AC and MUC6 tended to decrease, whereas MUC1 expression was elevated. MUC2 and CK20 were infrequently expressed in all of the gallbladder epithelia, but adenomas expressing MUC2 and/or CK20 were more frequently associated with carcinomas and showed a higher grade of atypia than those without these antigens. In carcinomas, MUC1 expression was related to invasive growth, lymph node metastasis and a non-papillotubular type, whereas MUC6 expression was related to non-invasive growth. CK7 was diffusely expressed in almost all lesions, but carcinomas with a loss of CK7 expression showed poor survival. In conclusion, normal gallbladder mucosa has a gastric phenotype, but during carcinogenesis and tumor progression, the gastric phenotype is gradually lost and the aberrant expression of MUC1 occurs. The intestinal phenotype is not common in the gallbladder.
为了评估黏蛋白和细胞角蛋白表达改变在胆囊癌发生过程中的意义，我们对33例正常黏膜、31例腺瘤、55例发育异常和131例胆囊癌中MUC1、MUC2、MUC5AC、MUC6、CK7和CK20的表达谱进行了特征分析。在正常胆囊黏膜中，MUC5AC和MUC6呈弥漫性表达，而MUC1不表达。然而，在腺瘤、发育异常和癌组织中，MUC5AC和MUC6的表达趋于降低，而MUC1的表达升高。MUC2和CK20在所有胆囊上皮中均很少表达，但表达MUC2和/或CK20的腺瘤比不表达这些抗原的腺瘤更易发生癌变，且异型性更高。在癌组织中，MUC1的表达与浸润性生长、淋巴结转移及非乳头管状类型有关，而MUC6的表达与非浸润性生长有关。CK7在几乎所有病变中均呈弥漫性表达，但CK7表达缺失的癌组织患者生存率较低。总之，正常胆囊黏膜具有胃型表型，但在癌变和肿瘤进展过程中，胃型表型逐渐丧失，MUC1出现异常表达。肠型表型在胆囊中并不常见。
