Ishigami Sumiya, Natsugoe Shoji, Okumura Hiroshi, Matsumoto Masataka, Nakajo Akihiro, Uenosono Yoshikazu, Arigami Takaaki, Uchikado Yasuto, Setoyama Tetsuro, Arima Hideo, Hokita Shuichi, Aikou Takashi
Digestive Surgery Surgical Oncology, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Ann Surg Oncol. 2007 Nov;14(11):3154-8. doi: 10.1245/s10434-007-9521-6. Epub 2007 Jul 26.
Recent research has revealed that tumor cells expressing chemokine receptors have a crucial impact on patient survival. However, there is no information regarding chemokine expression in gastro-intestinal cancer. This study immunohistochemically investigated CXCL12 expression in gastric cancer and evaluated its association with clinical factors, including patient prognosis.
A total of 185 gastric cancer patients receiving curative gastrectomy were assessed. CXCL12 expression was evaluated by immunohistochemical analysis. Tumors with CXCL12-positive cancer cells were regarded as CXCL12 positive, and according to the degree of CXCL12 expression, patients were divided into three groups (weak, 31 cases; moderate, 27 cases; strong, 20 cases). Correlations between CXCL12 expression and clinical factors in gastric cancer were then determined.
CXCL12 was found in the cellular membrane of cancer cells. Seventy-four of 185 patients were classified into the CXCL12-positive group. Patients were divided into three groups according to the positivity of CXCL12 expression. Significant associations between CXCL12 and lymph node metastases (p < 0.05), depth of invasion (p < 0.01), lymphatic invasion (p < 0.01), tumor diameter (p < 0.05), and clinical stage (p < 0.01) were seen. Univariate analysis revealed that the CXCL12-positive group had significantly poorer surgical outcome than the CXCL12-negative group (p < 0.01). Multivariate analysis revealed CXCL12 to be an independent prognostic factor in gastric cancer (p = 0.02).
Cancerous CXCL12 positivity was determined to be an independent prognostic factor in gastric cancer, with CXCL12-positive gastric cancer showing more-aggressive behavior. Autocrine CXCL12 secretion from tumor cells may activate CXCR-4 on the tumor cells, which may be related to of the viability of distant metastases.
近期研究表明，表达趋化因子受体的肿瘤细胞对患者生存有着至关重要的影响。然而，关于胃肠道癌中趋化因子的表达情况尚无相关信息。本研究采用免疫组织化学方法对胃癌中CXCL12的表达进行了研究，并评估了其与包括患者预后在内的临床因素之间的关联。
对185例行根治性胃切除术的胃癌患者进行了评估。通过免疫组织化学分析评估CXCL12的表达。CXCL12阳性癌细胞的肿瘤被视为CXCL12阳性，并根据CXCL12的表达程度将患者分为三组（弱阳性，31例；中度阳性，27例；强阳性，20例）。然后确定CXCL12表达与胃癌临床因素之间的相关性。
在癌细胞的细胞膜中发现了CXCL12。185例患者中有74例被归类为CXCL12阳性组。根据CXCL12表达的阳性情况将患者分为三组。CXCL12与淋巴结转移（p < 0.05）、浸润深度（p < 0.01）、淋巴管浸润（p < 0.01）、肿瘤直径（p < 0.05）和临床分期（p < 0.01）之间存在显著关联。单因素分析显示，CXCL12阳性组的手术结果明显比CXCL12阴性组差（p < 0.01）。多因素分析显示CXCL12是胃癌的独立预后因素（p = 0.02）。
癌组织中CXCL12阳性被确定为胃癌的独立预后因素，CXCL12阳性的胃癌表现出更具侵袭性的行为。肿瘤细胞自分泌CXCL12可能会激活肿瘤细胞上的CXCR-4，这可能与远处转移的生存能力有关。
