Foda Abd AlRahman Mohammad, El-Hawary Amira Kamal, Hamed Hazem
Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt.
Pathol Oncol Res. 2016 Oct;22(4):725-32. doi: 10.1007/s12253-016-0060-y. Epub 2016 Apr 9.
CRC is a heterogeneous disease in terms of morphology, invasive behavior, metastatic capacity, and clinical outcome. Recently, many so-called mesothelial markers, including calretinin, D2-40, WT1, thrombomodulin, mesothelin, and others, have been certified. The aim of this study was to assess the immunohistochemical expression of calretinin and other mesothelial markers (D2-40 and mesothelin) in colorectal mucinous adenocarcinoma (MA) and non mucinous adenocarcinoma (NMA) specimens and relation to clinicopathological features and prognosis using manual tissue microarray technique. We studied tumor tissue specimens from 150 patients with colorectal MA and NMA who underwent radical surgery from January 2007 to January 2012. High-density manual tissue microarrays were constructed using a modified mechanical pencil tip technique, and paraffin sections were submitted for immunohistochemistry using Calretinin, D2-40 and mesothelin expressions. We found that NMA showed significantly more calretinin and D2-40 expression than MA In contrast, no statistically significant difference between NMA and MA was detected in mesothelin expression. There were no statistically significant relations between any of the clinicopathological or histological parameters and any of the three markers. In a univariate analysis, neither calretinin nor D2-40 expressions showed any significant relations to DFS or OS. However, mesothelin luminal expression was significantly associated with worse DFS. Multivariate Cox regression analysis proved that luminal mesothelin expression was an independent negative prognostic factor in NMA. In conclusion, Calretinin, D2-40 and mesothelin are aberrantly expressed in a proportion of CRC cases with more expression in NMA than MA. Aberrant expression of these mesothelial markers was not associated with clinicopathological or histological features of CRCs. Only mesothelin expression appears to be a strong predictor of adverse prognosis.
就形态学、侵袭行为、转移能力和临床结果而言，结直肠癌是一种异质性疾病。最近，许多所谓的间皮标志物，包括钙结合蛋白、D2-40、WT1、血栓调节蛋白、间皮素等，已得到认证。本研究的目的是使用手动组织微阵列技术评估钙结合蛋白和其他间皮标志物（D2-40和间皮素）在结直肠黏液腺癌（MA）和非黏液腺癌（NMA）标本中的免疫组化表达，并探讨其与临床病理特征及预后的关系。我们研究了2007年1月至2012年1月期间接受根治性手术的150例结直肠MA和NMA患者的肿瘤组织标本。采用改良的机械铅笔尖技术构建高密度手动组织微阵列，并将石蜡切片用于检测钙结合蛋白、D2-40和间皮素的免疫组化表达。我们发现，NMA中钙结合蛋白和D2-40的表达明显多于MA。相比之下，NMA和MA之间的间皮素表达未检测到统计学上的显著差异。任何临床病理或组织学参数与这三种标志物中的任何一种之间均无统计学上的显著关系。在单因素分析中，钙结合蛋白和D2-40的表达与无病生存期（DFS）或总生存期（OS）均无显著关系。然而，间皮素腔内表达与较差的DFS显著相关。多因素Cox回归分析证明，腔内间皮素表达是NMA的独立阴性预后因素。总之，钙结合蛋白、D2-40和间皮素在一部分结直肠癌病例中异常表达，NMA中的表达多于MA。这些间皮标志物的异常表达与结直肠癌的临床病理或组织学特征无关。只有间皮素表达似乎是不良预后的有力预测指标。
