Moris Demetrios, Schizas Dimitrios, Michalinos Adamantios, Kanavidis Prodromos, Dimitrokallis Nikolaos, Alexandrou Andreas, Misiakos Evangelos, Liakakos Theodoros
Department of Immunology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
J BUON. 2017 Mar-Apr;22(2):403-409.
Gastric cancer (GC) is still one of the most common malignancies with the majority of the tumors diagnosed at advanced stage. The need for identification of prognostic and early detection biomarkers is thus compulsory. Claudins are biomarkers that are currently evaluated in the literature in the frame of epithelial-mesenchymal transition. The purpose of this investigation was to study the expression of claudin-4 in the various histological subtypes of GC and to evaluate its prognostic value.
This investigation was performed on gastric tumors obtained from 66 (46 men and 20 women) patients with documented gastric adenocarcinoma who underwent total or partial gastrectomy and regional lymphadenectomy from 2003 till 2011. Features such as tumor size, depth of invasion, grade and histological subtype, lymphovascular space invasion and regional lymph nodes involvement were also evaluated. Immunohistochemistry (IHC) was used for assessing the expression of claudin-4 with a semi-quantitative model.
66.7% of our cases showed abnormal claudin-4 expression in IHC. Claudin-4 was significantly correlated with tumor T stage and with intestinal type classification. The correlation of claudin-4 tissue expression with patient overall survival survival (OS) or disease-free survival (DFS) was not statistically significant, as well as with age, gender, tumor N stage, grade, TNM stage, positive lymph node ratio or lymphovascular invasion.
Literature stands equivocal about the exact role and prognostic value of claudin-4 and histopathology and tumor invasiveness in patients with GC. Our results further strengthen the need of larger studies to fully elucidate the predictive role of claudin-4 in the natural history of GC.
胃癌（GC）仍是最常见的恶性肿瘤之一，大多数肿瘤在晚期被诊断出来。因此，识别预后和早期检测生物标志物是必不可少的。紧密连接蛋白是目前在文献中以上皮-间质转化为框架进行评估的生物标志物。本研究的目的是研究紧密连接蛋白-4在胃癌各种组织学亚型中的表达，并评估其预后价值。
本研究对2003年至2011年期间接受全胃或部分胃切除术及区域淋巴结清扫术的66例（46例男性和20例女性）有记录的胃腺癌患者的胃肿瘤进行了研究。还评估了肿瘤大小、浸润深度、分级和组织学亚型、淋巴管间隙浸润和区域淋巴结受累等特征。免疫组织化学（IHC）用于通过半定量模型评估紧密连接蛋白-4的表达。
66.7%的病例在免疫组织化学中显示紧密连接蛋白-4表达异常。紧密连接蛋白-4与肿瘤T分期和肠型分类显著相关。紧密连接蛋白-4组织表达与患者总生存期（OS）或无病生存期（DFS）的相关性无统计学意义，与年龄、性别、肿瘤N分期、分级、TNM分期、阳性淋巴结比例或淋巴管浸润也无相关性。
关于紧密连接蛋白-4的确切作用及其在胃癌患者中的预后价值以及组织病理学和肿瘤侵袭性，文献尚无定论。我们的结果进一步强化了开展更大规模研究以充分阐明紧密连接蛋白-4在胃癌自然病程中的预测作用的必要性。
