Wu Ze-Yu, Zhan Wen-Hua, Li Jing-Hua, He Yu-Long, Wang Jian-Ping, Lan Ping, Peng Jun-Sheng, Cai Shi-Rong
Department of Gastrointestinal and Pancreatic Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
World J Gastroenterol. 2005 May 28;11(20):3139-43. doi: 10.3748/wjg.v11.i20.3139.
To examine the expression of E-cadherin in the primary tumor and to evaluate its relationship with lymph node micrometastasis (LNM).
The authors studied 850 lymph nodes resected from 30 patients with gastric carcinoma who underwent gastrectomy with lymphadenectomy using reverse transcription polymerase chain reaction (RT-PCR) assay in addition to H and E staining. Cytokeratin-20 (CK-20) gene marker was used in this assay. The level of E-cadherin expression in the primary tumor was examined by immunochemical technique (EliVision plus).
LNM was detected in 77 (12.5%) lymph nodes of 14 patients (46.7%) with gastric carcinoma. The incidence of LNM was significantly higher in the diffuse type (12 of 19 cases, 63.2%) than in the intestinal type of gastric carcinoma (2 of 11 cases, 18.2%, P = 0.026). The incidence of LNM also increased in accordance with the depth of tumor invasion. The loss of expression of E-cadherin in primary tumors was found in 14 (46.7) of 30 tumors. The absence of E-cadherin expression was significantly associated with the Lauren classification (P = 0.026), lymph node metastasis (P = 0.011), the grade of differentiation (P = 0.004) and the lymphatic invasion (P = 0.001). Expression of E-cadherin was negative in 10 (71.4%) of the 14 patients with LNM, and in 4 (25%) of the 16 patients without LNM (P = 0.026).
The current results indicate that the RT-PCR assay is useful for the detection of LNM and can significantly increase the detection rate of lymph node metastasis in patients with gastric carcinoma. The Lauren classification and depth of tumor invasion are significantly associated with lymph node micrometastases. Our findings also indicate that E-cadherin may play an important role in determining the growth type and differentiation of gastric carcinoma. The loss of E-cadherin expression may contribute to LNM.
检测E-钙黏蛋白在原发性肿瘤中的表达，并评估其与淋巴结微转移（LNM）的关系。
作者对30例行胃癌根治术及淋巴结清扫术患者切除的850枚淋巴结进行研究，除苏木精-伊红（H&E）染色外，还采用逆转录聚合酶链反应（RT-PCR）检测法。本检测采用细胞角蛋白20（CK-20）基因标志物。原发性肿瘤中E-钙黏蛋白的表达水平采用免疫化学技术（EliVision plus）检测。
在14例（46.7%）胃癌患者的77枚（12.5%）淋巴结中检测到LNM。弥漫型胃癌（19例中的12例，63.2%）的LNM发生率显著高于肠型胃癌（11例中的2例，18.2%，P = 0.026）。LNM发生率也随肿瘤浸润深度增加而升高。30例肿瘤中有14例（46.7%）原发性肿瘤出现E-钙黏蛋白表达缺失。E-钙黏蛋白表达缺失与Lauren分型（P = 0.026）、淋巴结转移（P = 0.011）、分化程度（P = 0.004）及淋巴管浸润（P = 0.001）显著相关。14例发生LNM的患者中有10例（71.4%）E-钙黏蛋白表达为阴性，16例未发生LNM的患者中有4例（25%）E-钙黏蛋白表达为阴性（P = 0.026）。
目前结果表明，RT-PCR检测法有助于检测LNM，可显著提高胃癌患者淋巴结转移的检出率。Lauren分型和肿瘤浸润深度与淋巴结微转移显著相关。我们的研究结果还表明，E-钙黏蛋白可能在决定胃癌的生长类型和分化中起重要作用。E-钙黏蛋白表达缺失可能促成LNM。
