Dokowe Vutisa, Songwe Mupeta, Mumba Chibamba, Kayamba Violet
University Teaching Hospital, Department of Pathology and Microbiology, Nationalist Road, Private Bag RW IX, Lusaka, Zambia.
University of Zambia, School of Medicine, Nationalist Road, PO Box 50110, Lusaka, Zambia.
Med J Zambia. 2025;52(3):290-297. Epub 2025 Feb 6.
Gastric cancer (GC) is the one of the most common cancers globally and can be classified as diffuse, intestinal or mixed. Epithelial-cadherin (E-cadherin) is a transmembrane glycoprotein which plays a role in maintaining cell shape and extracellular matrix and its loss or reduction has been observed in gastric carcinogenesis. The aim of the study was to determine the proportion of loss of E-cadherin expression in GC.
Archival formalin fixed paraffin embedded GC tissues and their basic characteristics were retrieved from the histopathology laboratory at the University Teaching Hospital in Lusaka. Sections of the tissue were stained with haematoxylin and eosin to allow for typing of the GC and immunohistochemically stained with an antibody against E-cadherin. Data analysis was conducted using Stata version 15.
We successfully stained 31 archival GC tissues after excluding those not meeting quality checks. Among the samples included, 18 (58%) were from females. The median age was 51 years, IQR 40-68. Overall, 11 (36%) showed loss of E-cadherin expression. Young age was associated with E-cadherin loss (p=0.02). Histologically, 10 (32%) of the GC were of the diffuse type, 18 (58%) intestinal type and 3 (10%) mixed type. E-cadherin loss was significantly higher in diffuse type 7 (70%) than the Intestinal 2 (18%) or 2 (67%) the mixed types (p=0.003). In multivariable analysis, the difference remained significant (p=0.041). The proportion of E-cadherin loss was higher in tumours located in the cardia, 57%, when compared to those that were non-cardia in location, 29%, but the difference was not statistically significant [OR 3.2; 95% CI 0.4-27, p=0.21].
Loss of E-cadherin expression is associated with a younger age at diagnosis and with diffuse type gastric cancer. Results from this study could contribute toward patient prognostication and possibly influence therapeutic choices for GC patients in Zambia.
胃癌（GC）是全球最常见的癌症之一，可分为弥漫型、肠型或混合型。上皮钙黏蛋白（E-cadherin）是一种跨膜糖蛋白，在维持细胞形态和细胞外基质方面发挥作用，在胃癌发生过程中观察到其表达缺失或减少。本研究的目的是确定胃癌中E-cadherin表达缺失的比例。
从卢萨卡大学教学医院的组织病理学实验室获取存档的福尔马林固定石蜡包埋的胃癌组织及其基本特征。组织切片用苏木精和伊红染色以进行胃癌分型，并用抗E-cadherin抗体进行免疫组织化学染色。使用Stata 15版本进行数据分析。
在排除不符合质量检查的组织后，我们成功对31份存档的胃癌组织进行了染色。在所纳入的样本中，18例（58%）来自女性。中位年龄为51岁，四分位间距为40 - 68岁。总体而言，11例（36%）显示E-cadherin表达缺失。年轻与E-cadherin缺失相关（p = 0.02）。组织学上，10例（32%）胃癌为弥漫型，18例（58%）为肠型，3例（10%）为混合型。弥漫型中E-cadherin缺失明显高于肠型的2例（18%）或混合型的2例（67%）（p = 0.003）。在多变量分析中，差异仍然显著（p = 0.041）。与非贲门部肿瘤（29%）相比，位于贲门部的肿瘤中E-cadherin缺失比例更高，为57%，但差异无统计学意义[比值比3.2；95%置信区间0.4 - 27，p = 0.21]。
E-cadherin表达缺失与诊断时年龄较轻以及弥漫型胃癌相关。本研究结果有助于患者的预后评估，并可能影响赞比亚胃癌患者的治疗选择。
