Nomura Takashi, Kamio Yukinori, Takasu Naoki, Moriya Toshiyuki, Takeshita Akiko, Mizutani Masaomi, Hachiya Osamu, Hirai Ichiro, Kimura Wataru
Department of Gastroenterological and General Surgery, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
J Hepatobiliary Pancreat Surg. 2009;16(4):493-501. doi: 10.1007/s00534-009-0081-y. Epub 2009 Apr 10.
BACKGROUND/PURPOSE: We aimed to clarify the association between the presence of micrometastases around liver metastases from gastric cancer and the results of hepatic resection. In addition, we investigated the influence of E-cadherin and matrix metalloproteinase (MMP)-7 expression on the development of micrometastases.
Micrometastases around liver metastases were examined microscopically in 31 metastatic liver tumor specimens resected from 17 patients who had undergone hepatic resection for liver metastases from gastric cancer. E-cadherin and MMP-7 expression in the primary gastric tumor, the liver metastases, and the micrometastases were examined immunohistochemically.
Hepatic micrometastases were present in around 48% of the liver metastases, accounting for 59% of the patients. The tumor recurrence rate in the remnant liver after hepatic resection was significantly higher, and survival significantly poorer, in patients with such micrometastases than in those without. Micrometastases tended to appear around the liver metastases that had reduced E-cadherin expression. Most of the micrometastases in the lymph ducts and sinusoids showed reduced E-cadherin expression. MMP-7 expression was not correlated with the presence of micrometastases.
About half of the hepatic metastases from gastric cancer had seeded off micrometastases, and the presence of these micrometastases was associated with a poorer result of hepatic resection. Reduced E-cadherin expression in metastatic liver tumors may be associated with the development of micrometastases.
背景/目的：我们旨在阐明胃癌肝转移灶周围微转移的存在与肝切除结果之间的关联。此外，我们研究了E-钙黏蛋白和基质金属蛋白酶（MMP）-7表达对微转移发生发展的影响。
对17例因胃癌肝转移接受肝切除的患者切除的31个转移性肝肿瘤标本进行显微镜检查，以检测肝转移灶周围的微转移。采用免疫组织化学方法检测原发性胃癌、肝转移灶和微转移灶中E-钙黏蛋白和MMP-7的表达。
约48%的肝转移灶存在肝内微转移，占患者总数的59%。有微转移的患者肝切除术后残余肝内的肿瘤复发率显著更高，生存率显著更低。微转移倾向于出现在E-钙黏蛋白表达降低的肝转移灶周围。淋巴管和肝血窦中的大多数微转移灶E-钙黏蛋白表达降低。MMP-7表达与微转移的存在无关。
约一半的胃癌肝转移存在微转移，这些微转移的存在与肝切除结果较差有关。转移性肝肿瘤中E-钙黏蛋白表达降低可能与微转移的发生发展有关。
