Teixeira C R, Tanaka S, Haruma K, Yoshihara M, Sumii K, Kajiyama G, Shimamoto F
First Department of Internal Medicine, Hiroshima University School of Medicine, Japan.
Oncology. 1994 May-Jun;51(3):228-33. doi: 10.1159/000227339.
Immunohistochemical carcinoembryonic antigen (CEA) staining patterns at the invasive tumor margin were correlated with malignant potential in 64 advanced colorectal carcinomas. Twenty-two (34%) carcinomas showed an apical and 42 (66%) a cytoplasmic staining pattern. Carcinomas with a cytoplasmic pattern had a higher incidence of lymph node (71 versus 41%; p < 0.05) and liver (50 versus 23%; p < 0.05) metastasis and higher levels of serum CEA (p < 0.01) than those with an apical staining pattern. Nine of 11 recurrent tumors had a cytoplasmic pattern and 2 had an apical pattern (p < 0.05). Among carcinomas having the same degree of differentiation, those with a cytoplasmic CEA staining pattern were more aggressive. Six (55%) well-differentiated carcinomas with a cytoplasmic pattern metastasized to the liver while none with an apical pattern did (p < 0.05). Moderately differentiated carcinomas with a cytoplasmic pattern had a significantly higher incidence of lymph node metastasis than those with an apical pattern (77 versus 46%; p < 0.05). When colorectal carcinomas are examined at the invasive tumor margin, an evaluation of the CEA staining pattern is useful in recognizing carcinomas having a higher potential to metastasize and recur after curative surgery.
对64例晚期结直肠癌患者，研究了浸润性肿瘤边缘的免疫组织化学癌胚抗原（CEA）染色模式与恶性潜能的相关性。22例（34%）癌表现为顶端染色模式，42例（66%）表现为细胞质染色模式。与顶端染色模式的癌相比，细胞质染色模式的癌发生淋巴结转移（71%对41%；p<0.05）和肝转移（50%对23%；p<0.05）的发生率更高，血清CEA水平也更高（p<0.01）。11例复发性肿瘤中有9例为细胞质染色模式，2例为顶端染色模式（p<0.05）。在分化程度相同的癌中，具有细胞质CEA染色模式的癌侵袭性更强。6例（55%）高分化细胞质染色模式的癌发生肝转移，而顶端染色模式的癌均未发生肝转移（p<0.05）。细胞质染色模式的中分化癌发生淋巴结转移的发生率显著高于顶端染色模式的癌（77%对46%；p<0.05）。在浸润性肿瘤边缘检查结直肠癌时，评估CEA染色模式有助于识别具有较高转移潜能和根治性手术后复发潜能的癌。
