Department of Surgery, Division of Surgical Oncology, University of Tokyo, Tokyo, Japan.
Ann Surg Oncol. 2011 Aug;18(8):2281-8. doi: 10.1245/s10434-011-1562-1. Epub 2011 Feb 3.
The role and clinical significance of the alteration of sympathetic nerve fibers (SNF) was assessed in gastric cancer. Loss of nerve fibers in malignant tumors has previously been described; however, how dysfunction of the nervous system is involved in cancer progression has not been clarified in clinical studies.
The distribution of SNF was examined in 82 surgically resected gastric cancer specimens with immunohistochemical staining of tyrosine hydroxylase (TH), and the association with clinicopathological findings as well as the clinical outcome of the patients was retrospectively evaluated.
Arterioles in the normal gastric wall were totally covered with SNF, while the immunoreactivity to TH was markedly reduced around arterioles in cancer tissue. The degree of loss of SNF was significantly correlated with the depth of invasion (P < .0001) and lymph node metastasis (P < .0001) as well as microvessel density (MVD) (P = .0043). Moreover, patients who had tumors with marked loss of SNF showed a markedly worse clinical outcome, with an independent association by multivariate analysis.
Loss of periarteriolar SNF is associated with aggressive phenotype of gastric cancer possibly through enhanced angiogenesis and thus could be a useful marker to predict the clinical outcome.
本研究旨在评估交感神经纤维（SNF）改变在胃癌中的作用和临床意义。先前的研究已经描述了恶性肿瘤中神经纤维的丢失，然而，神经系统功能障碍如何参与癌症的进展，在临床研究中尚未阐明。
采用酪氨酸羟化酶（TH）免疫组织化学染色法，对 82 例手术切除的胃癌标本中的 SNF 分布进行了检测，并回顾性评估了其与临床病理特征以及患者临床结局的相关性。
正常胃壁的小动脉完全被 SNF 覆盖，而在癌组织中小动脉周围的 TH 免疫反应明显减弱。SNF 缺失的程度与浸润深度（P <.0001）、淋巴结转移（P <.0001）以及微血管密度（MVD）（P =.0043）显著相关。此外，SNF 缺失明显的肿瘤患者临床结局明显较差，多因素分析显示其与独立预后因素相关。
围绕小动脉的 SNF 缺失与胃癌侵袭性表型相关，可能通过促进血管生成而发挥作用，因此可能成为预测临床结局的有用标志物。
