Nakazawa Nobuhiro, Sohda Makoto, Ide Munenori, Shimoda Yuki, Sano Akihiko, Sakai Makoto, Oyama Tetsunari, Shirabe Ken, Saeki Hiroshi
Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan.
Department of Diagnostic Pathology, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan.
Oncol Lett. 2024 Jul 3;28(3):420. doi: 10.3892/ol.2024.14554. eCollection 2024 Sep.
The present study examined the surgical outcome and prognosis of patients with poorly cohesive carcinoma (PCC), and characterized the molecular pathological factors, epithelial-mesenchymal transition (EMT) and interstitial signals of the disease. A total of 281 patients who underwent gastric cancer (GC) surgery between April 2015 and August 2020 were included. Furthermore, tissue samples from another 197 patients with GC who underwent surgery between 1999 and 2003 were assessed using a tissue microarray. Preoperatively treated cases and endoscopic submucosal dissection cases were excluded, and multiple blocks containing the invasion region were collected for tissue microarray. For tissue microarray analysis, the clinicopathological factors of protein wnt3a (wnt3a), leucine-rich repeat-containing G-protein coupled receptor 5, transforming growth factor-β-induced, phosphorylated serine/threonine-protein kinase mTOR and E-cadherin expression were collected as EMT markers. The results of the surgical case evaluation and tissue microarray indicated that PCC was more common in younger patients and women, as the ratio of women to men was higher in the PCC group compared with that in the non-PCC group. However, none of the results revealed that the prognosis was worse in all patients with PCC compared with the non-PCC group. Furthermore, in the tissue microarray study, PCC samples exhibited significantly decreased expression of the cell adhesion molecule E-cadherin, suggesting enhanced EMT, which activates wnt3a signaling. PCC with increased EMT was significantly associated with a poor prognosis.
本研究对低黏附性癌（PCC）患者的手术结果和预后进行了检查，并对该疾病的分子病理因素、上皮-间质转化（EMT）和间质信号进行了特征分析。纳入了2015年4月至2020年8月期间接受胃癌（GC）手术的281例患者。此外，使用组织芯片对1999年至2003年期间接受手术的另外197例GC患者的组织样本进行了评估。排除术前治疗病例和内镜黏膜下剥离病例，并收集包含浸润区域的多个组织块用于制作组织芯片。对于组织芯片分析，收集蛋白wnt3a（wnt3a）、富含亮氨酸重复序列的G蛋白偶联受体5、转化生长因子-β诱导的磷酸化丝氨酸/苏氨酸蛋白激酶mTOR和E-钙黏蛋白表达的临床病理因素作为EMT标志物。手术病例评估和组织芯片的结果表明，PCC在年轻患者和女性中更为常见，因为PCC组中女性与男性的比例高于非PCC组。然而，所有结果均未显示与非PCC组相比，所有PCC患者的预后更差。此外，在组织芯片研究中，PCC样本中细胞黏附分子E-钙黏蛋白的表达显著降低，提示EMT增强，这激活了wnt3a信号通路。EMT增加的PCC与不良预后显著相关。
