Ishigami Sumiya, Natsugoe Shoji, Nakajo Aikihiro, Tokuda Koki, Uenosono Yoshikazu, Arigami Takaaki, Matsumoto Masataka, Okumura Hiroshi, Hokita Shuichi, Aikou Takashi
Department of Surgical Oncology, Kagoshima University School of Medicine, Kagoshima, Japan.
Hepatogastroenterology. 2007 Jun;54(76):1025-8.
BACKGROUND/AIMS: Chemokine receptor CCR7 is a key molecule for migration of lymphocytes and dendritic cells into lymph nodes. Expression of CCR7 in tumor cells has been reported in malignancies, and CCR7 expression in tumor cells has been investigated in vitro and in vivo. However, there is little information regarding the clinical implications of CCR7-positive gastric cancer.
A total of 224 gastric cancer patients who underwent curative surgery in Kagoshima University Hospital were enrolled. CCR7 expression in the primary tumor was detected by immunohistochemically. Patients showing more than 10% positivity for CCR7 were defined as having high CCR7 expression, as previously reported.
CCR7 expression was detected in cytoplasm and membrane of tumor cells and inflammatory cells in the tumor nest. CCR7-positive patients exhibited deeper tumor invasion, more frequent lymph node metastasis, higher rates of lymphatic invasion (p < 0.01) and more venous invasion (p < 0.05) than CCR7-negative patients. Multivariate regression analysis showed that the most significant clinical factor for CCR7 was lymph node metastasis followed by lymphatic invasion. CCR7-positive gastric cancer patients had significantly poorer surgical outcomes than CCR7-negative patients (p < 0.01). However, CCR7 was not selected as an independent prognostic factor.
Our results suggest that CCR7 expression in gastric cancer is related to the onset of preferential conditions for lymphatic spread, such as lymph node metastasis. Although CCR7 expression is not an independent prognostic factor, it may show strong correlations with other lymphatic factors. CCR7 expression of preoperative biopsy specimen can predict lymph node metastasis because of the close correlation with lymphatic factors.
背景/目的：趋化因子受体CCR7是淋巴细胞和树突状细胞迁移至淋巴结的关键分子。恶性肿瘤中已报道肿瘤细胞中有CCR7表达，并且已在体外和体内对肿瘤细胞中的CCR7表达进行了研究。然而，关于CCR7阳性胃癌的临床意义的信息较少。
纳入了在鹿儿岛大学医院接受根治性手术的224例胃癌患者。通过免疫组织化学检测原发肿瘤中的CCR7表达。如先前报道，CCR7阳性率超过10%的患者被定义为具有高CCR7表达。
在肿瘤巢中的肿瘤细胞和炎性细胞的细胞质和细胞膜中检测到CCR7表达。与CCR7阴性患者相比，CCR7阳性患者表现出更深的肿瘤浸润、更频繁的淋巴结转移、更高的淋巴管浸润率（p<0.01）和更多的静脉浸润（p<0.05）。多因素回归分析显示，CCR7最显著的临床因素是淋巴结转移，其次是淋巴管浸润。CCR7阳性胃癌患者的手术结局明显比CCR7阴性患者差（p<0.01）。然而，CCR7未被选为独立的预后因素。
我们的结果表明，胃癌中CCR7表达与淋巴结转移等淋巴管扩散的优先条件的发生有关。虽然CCR7表达不是独立的预后因素，但它可能与其他淋巴管因素有很强的相关性。术前活检标本的CCR7表达可预测淋巴结转移，因为它与淋巴管因素密切相关。
