Barresi V, Vitarelli E, Grosso M, Tuccari G, Barresi G
Department of Human Pathology, University of Messina, Italy.
Eur J Histochem. 2006 Oct-Dec;50(4):301-9.
Laurèn's system subdivides gastric cancers into an intestinal type and a diffuse type. This histological classification mirrors histogenetic hypotheses according to which the intestinal-type cancer derives from intestinal metaplasia and dysplasia, while the diffuse-type originates directly from gastric mucosa, with or without a preceding non-metaplastic dysplasia. Studies concerning mucins expression in gastric neoplastic and preneoplastic lesions have provided contradictory data concerning such histogenetic relationships. The aim of the present study was to verify whether a correlation between mucins phenotype and Lauren's classification subsists. 40 gastric adenocarcinomas, subdivided, according to Laurèn's classification, into 27 intestinal-type, 10 diffuse-type and 3 unclassified cases, were examined for MUC1 and MUC2 immunohistochemical expression. Intestinal-type carcinomas displayed a MUC1-positive staining in 23/27 cases and a MUC2-positive immunoreaction in 10/27 cases. Diffuse-type carcinomas expressed MUC1 in 3/10 and MUC2 in 8/10 cases, respectively. According to the mucins expression pattern, three phenotypes were identified: the gastric phenotype (MUC1+/MUC2-); the gastro-intestinal phenotype (MUC1+/MUC2+) and the intestinal phenotype (MUC1-/MUC2+). The gastric phenotype was significantly higherin intestinal-type adenocarcinomas, whereas cases showing an intestinal phenotype were significantly more frequent in diffuse-type adenocarcinomas. These findings provide evidence for a lack of correlation between Lauren's classification and MUC1 and MUC2 phenotypes. In particular, the term intestinal-type tumour as referred to gland-forming gastric cancer does not seem to reflect an immunohistochemical phenotype.
劳伦系统将胃癌分为肠型和弥漫型。这种组织学分类反映了组织发生学假说,即肠型癌源于肠化生和发育异常,而弥漫型癌直接起源于胃黏膜,无论有无先前的非化生发育异常。关于胃肿瘤性和肿瘤前病变中黏蛋白表达的研究,就这种组织发生学关系提供了相互矛盾的数据。本研究的目的是验证黏蛋白表型与劳伦分类之间是否存在相关性。对40例胃腺癌进行了检查,根据劳伦分类将其分为27例肠型、10例弥漫型和3例未分类病例,检测其MUC1和MUC2免疫组化表达。肠型癌在23/27例中显示MUC1阳性染色,在10/27例中显示MUC2阳性免疫反应。弥漫型癌分别在3/10例中表达MUC1,在8/10例中表达MUC2。根据黏蛋白表达模式,确定了三种表型:胃表型(MUC1+/MUC2-);胃肠表型(MUC1+/MUC2+)和肠表型(MUC1-/MUC2+)。胃表型在肠型腺癌中显著更高,而显示肠表型的病例在弥漫型腺癌中显著更常见。这些发现证明劳伦分类与MUC1和MUC2表型之间缺乏相关性。特别是,所谓的形成腺体的胃癌的肠型肿瘤这一术语似乎并未反映免疫组化表型。