Shinozaki Eiji, Adachi Shinya, Shoda Junichi, Kawamoto Toru, Suzuki Hideo, Irimura Tatsuro, Ohkohchi Nobuhiro
Department of Gastroenterological Surgery, Institute of Clinical Medicine, The University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki 305-8575, Japan.
Int J Oncol. 2004 Nov;25(5):1257-65.
Because of the complex nature of the diverse histologic grade in gastric carcinomas a useful biomarker should be provided to scale the aggressiveness of the disease and to determine surgical strategy, especially for advanced carcinomas. Our previous study of MUC1 in gallbladder carcinoma using mAb MY.1E12 has revealed the stromal localization of MUC1 adjacent to the carcinoma was correlated with poor prognosis. In gastric carcinoma the biological significance of the localization of MUC1 recognized by mAb MY.1E12 has not been fully investigated. We performed immunohistochemical analysis to determine the correlations with the localization of mAb MY.1E12-reactive-MUC1 (MY.1E12-MUC1) and clinicopathological findings. A total of 91 consecutive patients with stage II, IIIA or IIIB gastric carcinoma after curative resection were reviewed retrospectively. The localization of MY.1E12-MUC1 was classified as negative, apical, cytoplasmic or stromal type based on the predominant subcellular localization. Immunostaining of MY.1E12-MUC1 was recognized in 84% of the 55 cases of differentiated-type carcinoma and in 53% of the 36 cases of undifferentiated-type carcinoma (P<0.01). In differentiated-type carcinoma, the proportion of stromal-type dominant localization of MY.1E12-MUC1 was increased at the deepest invading sites. Postsurgical liver metastasis was seen in 11 (30%) of 37 cases showing stromal or cytoplasmic-type localization-dominant group and in 1 (6%) of 18 cases showing apical-type localization-dominant group or negative staining group (P<0.05). The postsurgical survival was significantly poorer in the former group than in the latter (P=0.004). In differentiated-type gastric carcinoma, the presence of the cytoplasmic- or stromal-type localization of MY.1E12-MUC1 at the deepest invading sites correlates with aggressiveness of the disease, such as the tendency to form liver metastasis. This phenotype may serve as a unique biological feature associated with the malignant behavior of differentiated-type gastric carcinomas.
由于胃癌组织学分级多样的复杂性质,应提供一种有用的生物标志物来衡量疾病的侵袭性并确定手术策略,尤其是对于进展期癌。我们之前使用单克隆抗体MY.1E12对胆囊癌中MUC1的研究表明,癌旁MUC1的基质定位与预后不良相关。在胃癌中,单克隆抗体MY.1E12识别的MUC1定位的生物学意义尚未得到充分研究。我们进行了免疫组织化学分析,以确定与单克隆抗体MY.1E12反应性MUC1(MY.1E12-MUC1)定位和临床病理结果的相关性。对91例根治性切除术后的II期、IIIA期或IIIB期胃癌患者进行了回顾性研究。根据主要的亚细胞定位,MY.1E12-MUC1的定位分为阴性、顶端、细胞质或基质型。在55例分化型癌病例中,84%的病例可识别出MY.1E12-MUC1免疫染色,在36例未分化型癌病例中,53%的病例可识别出该免疫染色(P<0.01)。在分化型癌中,MY.1E12-MUC1基质型优势定位的比例在最深浸润部位增加。37例显示基质或细胞质型定位优势组的患者中有11例(30%)出现术后肝转移,18例显示顶端型定位优势组或阴性染色组的患者中有1例(6%)出现术后肝转移(P<0.05)。前一组的术后生存率明显低于后一组(P=0.004)。在分化型胃癌中,最深浸润部位MY.1E12-MUC1的细胞质或基质型定位与疾病的侵袭性相关,如形成肝转移的倾向。这种表型可能是与分化型胃癌恶性行为相关的独特生物学特征。