Jo Min Jung, Lee Jun Ho, Nam Byung-Ho, Kook Myeong Cherl, Ryu Keun Won, Choi Il Ju, Kim Young-Woo, Bae Jae-Moon
Gastric Cancer Branch, National Cancer Center, Goyang-si, Gyeonggi-do, Korea.
Ann Surg Oncol. 2009 Jul;16(7):2052-7. doi: 10.1245/s10434-009-0474-9. Epub 2009 Apr 30.
Lymph node metastasis is the most important factor to consider when deciding on the modality of resection in patients with early gastric cancer. The aim of the present study was to assess the relationship between preoperative serum angiopoietin-2, a lymphangiogenic growth factor, and lymph node metastasis in patients with early gastric cancer.
A total of 62 preoperative serum samples from patients diagnosed with early gastric adenocarcinoma, and 30 serum samples from healthy donors were obtained. The serum levels of angiopoietin-2 (Ang-2) were quantified by immunoassay. Intra- and peritumor lymphatic vessel density (I-LVD and P-LVD) were counted after immunohistochemical staining. The relationship between the serum Ang-2 levels and other prognostic variables (tumor size, histological type, depth of tumor invasion, I-LDV, P-LDV, presence of lymph node involvement, and distant metastasis) were then examined by univariate and multivariate linear regression analyses.
The median serum levels of Ang-2 in patients were higher than those of healthy controls [311.1 ng/mL, interquartile range (IQR) 256.7-311.1 ng/mL versus 286.5 ng/mL, IQR 226.9-286.5 ng/mL; Mann-Whitney test, P = 0.016]. Eight patients had metastatic lymph nodes; the Ang-2 levels from the patients with metastatic lymph nodes were higher than from those with negative lymph nodes (297.5 ng/mL, IQR 251.1-385.8 ng/mL versus 416.0 ng/mL, IQR 337.1-485.5 ng/mL; Mann-Whitney test, P = 0.019). Elevated serum Ang-2 levels were associated with positive lymph node involvement and this finding was significant on univariate (P = 0.008) and multivariate logistic regression analysis (P = 0.011).
Serum Ang-2 levels were clinically useful markers for lymph node metastasis in patients with early gastric cancer.
在决定早期胃癌患者的切除方式时，淋巴结转移是需要考虑的最重要因素。本研究的目的是评估术前血清血管生成素-2（一种淋巴管生成生长因子）与早期胃癌患者淋巴结转移之间的关系。
共获取了62例诊断为早期胃腺癌患者的术前血清样本以及30例健康供者的血清样本。通过免疫测定法定量血清血管生成素-2（Ang-2）水平。免疫组化染色后计数肿瘤内及肿瘤周围淋巴管密度（I-LVD和P-LVD）。然后通过单因素和多因素线性回归分析检查血清Ang-2水平与其他预后变量（肿瘤大小、组织学类型、肿瘤浸润深度、I-LDV、P-LDV、淋巴结受累情况和远处转移）之间的关系。
患者血清Ang-2的中位数水平高于健康对照者[311.1 ng/mL，四分位间距（IQR）256.7 - 311.1 ng/mL，而健康对照者为286.5 ng/mL，IQR 226.9 - 286.5 ng/mL；Mann-Whitney检验，P = 0.016]。8例患者有转移性淋巴结；有转移性淋巴结患者的Ang-2水平高于无淋巴结转移患者（297.5 ng/mL，IQR 251.1 - 385.8 ng/mL，而无淋巴结转移患者为416.0 ng/mL，IQR 337.1 - 485.5 ng/mL；Mann-Whitney检验，P = 0.019）。血清Ang-2水平升高与淋巴结受累阳性相关，这一发现经单因素（P = 0.008）和多因素逻辑回归分析（P = 0.011）均具有显著性。
血清Ang-2水平是早期胃癌患者淋巴结转移的临床有用标志物。
