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腱生蛋白-C、纤连蛋白、层粘连蛋白、IV型胶原、α5β1和α9β1整合素以及消化道癌肝转移灶周围纤维性包膜形成的意义

Significance of tenascin-C, fibronectin, laminin, collagen IV, alpha5beta1 and alpha9beta1 integrins and fibrotic capsule formation around liver metastases originating from cancers of the digestive tract.

作者信息

Gulubova M V, Vlaykova T I

机构信息

Department of General and Clinical Pathology, Medical Faculty, Trakia University, 6000 Stara Zagora, Bulgaria.

出版信息

Neoplasma. 2006;53(5):372-83.

Abstract

The formation of a fibrotic capsule around liver metastases may functionally act as a barrier to local invasion. However, the prognostic significance of exstracellular matrix (ECM) and of some integrins' deposition around liver metastases remains unclear. An immunohistochemical investigation was carried out on 55 patients with synchronous liver metastases from colorectal and gastric cancers. Encapsulated metastases were detected in 60% of the cases. The 'non-capsular' cases showed clear immunostaining for tenascin-C, fibronectin, collagen IV, laminin, alphaSMA and integrins. On opposite, most of the cases with 'capsule' were negative for the studied ECM proteins and the two integrins. The patients with 'capsular' pattern had significantly longer median survival after the surgery compared to those with non-encapsulated metastases. The presence of tenascin, fibronectin, fibronectin receptor and laminin, as well as the strong immune signal for alphaSMA and collagen type IV in the sinusoids attached to the liver metastases was associated with a worse prognosis. The cells, forming ECM in the sinusoids attached to metastases in the 'non-capsular' pattern were alphaSMA-positive myofibroblasts. It was shown ultrastructurally that they were HSCs. The results indicate that fibrotic capsule formation is associated with longer survival after surgery. The appearance of tenascin-C and of its receptor at the periphery of liver metastases could be used as a sign of invasiveness.

摘要

肝转移灶周围纤维囊的形成可能在功能上起到局部侵袭屏障的作用。然而,细胞外基质(ECM)以及一些整合素在肝转移灶周围沉积的预后意义仍不明确。对55例结直肠癌和胃癌同步肝转移患者进行了免疫组织化学研究。60%的病例检测到有包膜的转移灶。“无包膜”病例中,肌腱蛋白-C、纤连蛋白、IV型胶原、层粘连蛋白、α平滑肌肌动蛋白(alphaSMA)和整合素呈明显免疫染色。相反,大多数“有包膜”病例中,所研究的ECM蛋白和两种整合素呈阴性。与无包膜转移灶的患者相比,“有包膜”型患者术后的中位生存期明显更长。肌腱蛋白、纤连蛋白、纤连蛋白受体和层粘连蛋白的存在,以及肝转移灶周围肝血窦中alphaSMA和IV型胶原的强免疫信号与较差的预后相关。在“无包膜”型转移灶周围肝血窦中形成ECM的细胞是alphaSMA阳性的肌成纤维细胞。超微结构显示它们是肝星状细胞(HSCs)。结果表明,纤维囊形成与术后更长的生存期相关。肌腱蛋白-C及其受体在肝转移灶周边的出现可作为侵袭性的标志。

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