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胃腺癌粘蛋白表型的预后意义及其与组织学分类的关系。

The prognostic significance of the mucin phenotype of gastric adenocarcinoma and its relationship with histologic classifications.

作者信息

Lee Ok-Jae, Kim Hyun-Jin, Kim Jang-Rak, Watanabe Hidenobu

机构信息

Department of Internal Medicine, Gyeongsang National University School of Medicine, Gyeongnam 660-702, Korea.

出版信息

Oncol Rep. 2009 Feb;21(2):387-93.

Abstract

The prognostic value of histologic classifications of gastric adenocarcinoma is controversial, although they have been commonly used. The clinical significance of the mucin phenotype has not been clarified. This study was conducted to determine the clinical significance of mucin phenotype as a possible prognostic factor. Mucin histochemistry by paradoxical concanavalin A (Con A) staining and immunostaining for 45M1, MUC2 glycoprotein and CD10 of mucin was performed in surgically obtained paraffin-embedded specimens from 106 gastric adenocarcinomas. We determined their mucin phenotypes and analyzed their relationships with clinical and histopathologic variables and survival rates. Among 106 gastric adenocarcinomas, 37 (34.9%), 35 (33.0%), 22 (20.8%) and 12 (11.3%) expressed the intestinal (I-), the gastric (G-), mixed (M-), and undetermined (U-) phenotypes, respectively. Although the mucin phenotype correlated well with histologic differentiation (p=0.000) and Lauren's classification of a tumor (p=0.003), it did not accord completely with them. There was no relationship between mucin phenotype and other patient clinicopathologic variables. No statistically significant difference in survival was observed among mucin phenotypes on univariate (p=0.089) and multivariate (p=0.088) analyses. However, the patients with I-phenotype tumor had a significantly better outcome than those with non-I-phenotype tumor on univariate (p=0.023) and multivariate (p=0.049) analyses. In conclusion, the mucin phenotype did not accord completely with histologic differentiation and Lauren's classification of gastric adenocarcinoma, despite a well-defined correlation between them. I-phenotypic expression, but not the histologic differentiation and Lauren's classification, was found to be an independent good prognostic factor of gastric cancers.

摘要

胃腺癌组织学分类的预后价值一直存在争议,尽管它们已被广泛应用。黏蛋白表型的临床意义尚未明确。本研究旨在确定黏蛋白表型作为一种可能的预后因素的临床意义。对106例胃腺癌手术切除的石蜡包埋标本进行了用异相伴刀豆球蛋白A(Con A)染色及对黏蛋白的45M1、MUC2糖蛋白和CD10进行免疫染色的黏蛋白组织化学分析。我们确定了它们的黏蛋白表型,并分析了它们与临床和组织病理学变量及生存率的关系。在106例胃腺癌中,分别有37例(34.9%)、35例(33.0%)、22例(20.8%)和12例(11.3%)表现为肠型(I-)、胃型(G-)、混合型(M-)和未定型(U-)表型。尽管黏蛋白表型与组织学分化(p=0.000)和肿瘤的劳伦分类(p=0.003)有很好的相关性,但并不完全与之相符。黏蛋白表型与其他患者临床病理变量之间没有关系。单因素(p=0.089)和多因素(p=0.088)分析显示,各黏蛋白表型之间在生存率上没有统计学显著差异。然而,单因素(p=0.023)和多因素(p=0.049)分析显示,I型表型肿瘤患者的预后明显优于非I型表型肿瘤患者。总之,尽管黏蛋白表型与胃腺癌组织学分化和劳伦分类之间有明确的相关性,但并不完全相符。发现I型表型表达而非组织学分化和劳伦分类是胃癌的一个独立良好预后因素。

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