Key Laboratory of Gastroenterology of Zhejiang Province, Hangzhou, China.
Anat Rec (Hoboken). 2010 Nov;293(11):1855-63. doi: 10.1002/ar.21230.
The aim of this study was to explore the clinical significance of neutrophil gelatinase-associated lipocalin (NGAL) in the development and prognosis of gastric cancer. NGAL tumor levels were determined in 333 GC patients by immunohistochemistry. NGAL in blood samples from 63 healthy donors and 60 gastric cancer patients were also determined by enzyme-linked immunosorbent assay. Rate of NGAL expression was correlated with the size of tumor (69.3% in >4 cm tumors vs. 46.1% in ≤4 cm tumors), Lauren's classification (84.3% in diffuse type vs. 28.2% in intestinal type), lymph node metastasis (75.6% vs. 16.4% with no metastasis), vascular invasion (74.9% vs. 26.8% with no invasion), distant metastasis (94.3% vs. 50.3% with no distant metastasis), and TNM stage (81.8% in TNM III+IV vs. 20.5% in TNM I+II). NGAL expression can be used as an independent prognostic factor in gastric cancer as indicated by multivariate analysis. Positivity for serum NGAL was higher than that for carbohydrate antigen determinant, CA19-9 (38.1% vs. 12.5%) in TNM I, and higher than that for carcinoembryonic antigen, CEA (58.3% vs. 8.3%) and CA19-9 (58.3% vs. 8.3%) in TNM II. In conclusion, serum NGAL has great potential to be used as an ancillary test for diagnosis of gastric cancer. Increased expression of NGAL in tumors suggests gastric cancer is likely to be at an advanced stage with invasion and metastasis, and also poor prognosis.
本研究旨在探讨中性粒细胞明胶酶相关脂质运载蛋白（NGAL）在胃癌发生发展及预后中的临床意义。采用免疫组织化学法检测 333 例 GC 患者的肿瘤 NGAL 水平，采用酶联免疫吸附法检测 63 例健康对照者和 60 例胃癌患者的血 NGAL。NGAL 表达率与肿瘤大小（>4cm 肿瘤为 69.3%，≤4cm 肿瘤为 46.1%）、Lauren 分型（弥漫型为 84.3%，肠型为 28.2%）、淋巴结转移（转移者为 75.6%，无转移者为 16.4%）、血管侵犯（侵犯者为 74.9%，无侵犯者为 26.8%）、远处转移（有远处转移者为 94.3%，无远处转移者为 50.3%）和 TNM 分期（Ⅲ+Ⅳ期为 81.8%，Ⅰ+Ⅱ期为 20.5%）密切相关。多因素分析表明，NGAL 表达可作为胃癌的独立预后因素。在 TNMⅠ期，血清 NGAL 阳性率高于 CA19-9（38.1% vs. 12.5%），在 TNMⅡ期，血清 NGAL 阳性率高于 CEA（58.3% vs. 8.3%）和 CA19-9（58.3% vs. 8.3%）。总之，血清 NGAL 具有作为胃癌辅助诊断的巨大潜力。肿瘤中 NGAL 的高表达提示胃癌可能处于晚期，具有侵袭和转移，且预后不良。
