Rocco A, Caruso R, Toracchio S, Rigoli L, Verginelli F, Catalano T, Neri M, Curia M C, Ottini L, Agnese V, Bazan V, Russo A, Pantuso G, Colucci G, Mariani-Costantini R, Nardone G
Department of Clinical and Experimental Medicine, Gastroenterology Unit, University Federico II, Naples, Italy.
Ann Oncol. 2006 Jun;17 Suppl 7:vii103-8. doi: 10.1093/annonc/mdl961.
Gastric adenomas are rare neoplastic growths characterized by localized polypoid proliferations of dysplastic epithelium that tend to progress to infiltrating adenocarcinoma. Therefore, the identification of molecular markers that could reliably recognize adenomas at risk of progression is advocated in the clinical management. In this study we investigated, in a series of gastric adenoma specimens from an area at high risk of gastric cancer, the relationship between clinicopathological characteristics of adenoma and Helicobacter pylori infection, APC mutational status, and COX-2 and the down-stream enzyme mPGES1 expression. Helicobacter pylori infection, detected in 24%, and 33% by histology and PCR analyses, respectively, did not show any relationship with growth pattern, localization, size, dysplasia grade and presence of synchronous cancer. Pathogenetic mutations of MCR region (codons 1269-1589) of the APC gene were detected only in one case corresponding to a single, small size, low grade, H. pylori-negative adenoma. The expression of COX-2 largely matched that of mPGES(1). Both were overexpressed in 79% of cases showing a relationship with high-grade dysplasia, size >10 mm and presence of a synchronous carcinoma. In conclusion, COX-2 may play a key role in the development and progression of gastric adenoma and could be an attractive target in the management of gastric adenoma at major risk of cancer development.
胃腺瘤是一种罕见的肿瘤性生长，其特征为发育异常的上皮细胞呈局限性息肉样增生，且有发展为浸润性腺癌的倾向。因此，在临床管理中提倡识别能够可靠识别有进展风险的腺瘤的分子标志物。在本研究中，我们在一系列来自胃癌高风险地区的胃腺瘤标本中，研究了腺瘤的临床病理特征与幽门螺杆菌感染、APC基因突变状态以及COX-2和下游酶mPGES1表达之间的关系。分别通过组织学和PCR分析检测到的幽门螺杆菌感染率为24%和33%，未显示与生长模式、定位、大小、发育异常程度和同步癌的存在有任何关系。APC基因MCR区域（密码子1269 - 1589）的致病突变仅在1例对应单个、小尺寸、低级别、幽门螺杆菌阴性的腺瘤中检测到。COX-2的表达与mPGES(1)的表达基本相符。在79%的病例中两者均过度表达，显示与高级别发育异常、大小>10 mm和同步癌的存在有关。总之，COX-2可能在胃腺瘤的发生和发展中起关键作用，并且可能是在有癌症发展重大风险的胃腺瘤管理中的一个有吸引力的靶点。
