Ishida T, Sugio K, Yokoyama K, Teteishi M, Oka T, Nishino T, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Nihon Geka Gakkai Zasshi. 1991 Sep;92(9):1107-10.
We immunohistochemically examined 186 lung adenocarcinomas for the presence of prognostic indicators of local growth of tumor, invasiveness and metastasis. Of the examined tumors, 67% showed a high expression of transforming growth factor alpha (TGF alpha); 50% for epidermal growth factor (EGF), 45% for EGF receptor (EGFR), and 30% for urokinase type plasminogen activator (uPA). In the EGFR-high cases, the 5-year survival rates of patients with high TGF alpha and low TGF alpha were 36% and 85%, respectively. In the EGFR-low cases, there was no statistical difference between the two groups. These findings suggested the presence of autocrine growth mechanisms. On the other hand, the high expression of uPA was modulated by TGF alpha and/or EGF. The 5-year survival rates of patients with high uPA and low uPA were 20% and 51%, respectively. The tumors with high expression of uPA showed degradation of the matrix components, including laminin and fibronectin. These findings suggested that uPA played a role to break through the surrounding basement membrane of blood and lymphatic vessels, and connective tissue for their growth and metastasis. We wish to emphasize the usefulness of the immunohistochemical evidences, such as autocrine growth mechanism and breakdown of extracellular matrix, as a possible parameters of tumor development, invasiveness and metastasis.
我们采用免疫组织化学方法检测了186例肺腺癌，以寻找肿瘤局部生长、侵袭和转移的预后指标。在所检测的肿瘤中，67%显示转化生长因子α（TGFα）高表达；50%为表皮生长因子（EGF），45%为EGF受体（EGFR），30%为尿激酶型纤溶酶原激活剂（uPA）。在EGFR高表达的病例中，TGFα高表达和低表达患者的5年生存率分别为36%和85%。在EGFR低表达的病例中，两组之间无统计学差异。这些发现提示存在自分泌生长机制。另一方面，uPA的高表达受TGFα和/或EGF调节。uPA高表达和低表达患者的5年生存率分别为20%和51%。uPA高表达的肿瘤显示包括层粘连蛋白和纤连蛋白在内的基质成分降解。这些发现提示uPA在突破肿瘤周围血管和淋巴管的基底膜以及结缔组织以实现其生长和转移方面发挥了作用。我们希望强调免疫组织化学证据的有用性，如自分泌生长机制和细胞外基质的破坏，作为肿瘤发生、侵袭和转移可能的参数。
