Yoshii Takako, Miyagi Yohei, Nakamura Yoshiyasu, Kobayashi Osamu, Kameda Yoichi, Ohkawa Shinichi
Division of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan.
Tumori. 2013 Mar-Apr;99(2):234-8. doi: 10.1177/030089161309900219.
Early gastric cancer without lymph node metastasis can be treated with minimally invasive endoscopic surgery. Hence, a better modality for predicting lymph node metastasis should be beneficial to early gastric cancer patients who may only require minimally invasive treatment. In vitro, phosphorylation of β-catenin induces the loss of membranous β-catenin and E-cadherin, subsequently increasing the potential for metastasis. We investigated the behavior of these molecules comparing lymph node metastasis-positive and lymph node metastasis-negative groups, using the specimens from the patients with early gastric cancer. This was a pilot research evaluating the usefulness of combined analysis of these molecules in predicting lymph node metastasis in early gastric cancer.
The clinicopathological features and immunohistochemical expression patterns of E-cadherin and β-catenin in the primary lesion were studied retrospectively in 28 patients (lymph node metastasis-positive versus lymph node metastasis-negative: 14 vs 14) selected from 272 patients. These patients underwent radical surgery for the early gastric cancer treatment from April 2000 to March 2004 at our hospital. All patients gave written informed consent to use their tissues for the clinical study. Statistical analyses were performed by the chi-square test and Mann-Whitney test.
More loss of membranous E-cadherin was observed in the lymph node metastasis-positive group than in the lymph node metastasis-negative group. Although the finding was slightly more marked in the intestinal than in the diffuse type early gastric cancer, there was no statistical significance. Loss of membranous β-catenin showed a similar trend and no statistical significance. When we evaluated the expression patterns of both molecules, dual loss of membranous E-cadherin and β-catenin significantly correlated with lymph node metastasis [dual loss in lymph node metastasis-positive versus lymph node metastasis-negative patients: 12 (86%) vs 6 (43%), P = 0.046]. Additionally, corresponding proportions in intestinal type early gastric cancer were 5 of 6 (83%) vs 0 of 6 (0%), P = 0.015.
Based on our results, the combined analysis of E-cadherin and β-catenin localizations may be helpful to accurately predict lymph node metastasis in intestinal type early gastric cancer.
无淋巴结转移的早期胃癌可采用微创内镜手术治疗。因此，一种更好的预测淋巴结转移的方法应有利于那些可能仅需微创治疗的早期胃癌患者。在体外，β-连环蛋白的磷酸化会导致膜性β-连环蛋白和E-钙黏蛋白缺失，进而增加转移潜能。我们使用早期胃癌患者的标本，比较了淋巴结转移阳性组和淋巴结转移阴性组中这些分子的表现。这是一项初步研究，评估这些分子联合分析在预测早期胃癌淋巴结转移中的实用性。
回顾性研究了从272例患者中选出的28例患者（淋巴结转移阳性与淋巴结转移阴性：14例对14例）原发性病变中E-钙黏蛋白和β-连环蛋白的临床病理特征及免疫组化表达模式。这些患者于2000年4月至2,004年3月在我院接受了早期胃癌根治手术。所有患者均书面同意将其组织用于临床研究。采用卡方检验和曼-惠特尼检验进行统计学分析。
淋巴结转移阳性组中膜性E-钙黏蛋白的缺失比淋巴结转移阴性组更多。虽然这一发现在肠型早期胃癌中比弥漫型早期胃癌中略为明显，但无统计学意义。膜性β-连环蛋白的缺失也呈现类似趋势，且无统计学意义。当我们评估这两种分子的表达模式时，膜性E-钙黏蛋白和β-连环蛋白的双重缺失与淋巴结转移显著相关[淋巴结转移阳性患者与淋巴结转移阴性患者的双重缺失：12例（86%）对6例（43%），P = 0.046]。此外，肠型早期胃癌中的相应比例分别为6例中的5例（83%）对6例中的0例（0%），P = 0.015。
基于我们的结果，E-钙黏蛋白和β-连环蛋白定位的联合分析可能有助于准确预测肠型早期胃癌的淋巴结转移。
