Kolodziejczyk P, Yao T, Oya M, Nakamura S, Utsunomiya T, Ishikawa T, Tsuneyoshi M
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Cancer. 1994 Dec 1;74(11):2896-907. doi: 10.1002/1097-0142(19941201)74:11<2896::aid-cncr2820741103>3.0.co;2-p.
Little is known about the changes in the immunohistochemical and histochemical characteristics that take place during the malignant transformation of gastric adenoma (GA).
Nine patients with GA who developed carcinoma (Group A) and 33 who did not (Group B) during an equivalent follow-up period (mean, 76.4 months; range, 38-166 months) were studied. Tissue sections from these patients were stained for p53, c-erbB-2, bcl-2, carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), and proliferating cell nuclear antigen (PCNA), and by high iron diamine-alcian blue staining. The gastric or intestinal phenotypes of the GA cells were evaluated histochemically by paradoxical concanavalin A and galactose oxidase-Schiff reactions.
In Group A, the following were more frequent; severe dysplasia (77.8% vs. 0%, P < 0.001), villous structures (66.7% vs. 9.1%, P < 0.05), sulfomucin secretion (88.9% vs. 39.4%, P < 0.05) and mixed gastric-intestinal phenotype (77.8% vs. 9.1%, P < 0.001). The development of carcinoma in Group A positively correlated with an increase in p53 expression and PCNA-labeling index. None of the adenomas was positive for c-erbB-2, but four of nine carcinomas showed positive reactions.
Mucin histochemistry of GA may be of some value in assessing the potential for subsequent carcinoma. Immunoexpression of c-erbB-2, bcl-2, CA 19-9, and CEA have only limited value. In contrast to p53, the immunoexpression of c-erbB-2 is a late event in the malignant transformation of GA.
关于胃腺瘤（GA）恶性转化过程中免疫组化和组织化学特征的变化，人们了解甚少。
研究了9例在相同随访期（平均76.4个月；范围38 - 166个月）内发生癌变的GA患者（A组）和33例未发生癌变的GA患者（B组）。对这些患者的组织切片进行p53、c-erbB-2、bcl-2、糖类抗原19-9（CA 19-9）、癌胚抗原（CEA）和增殖细胞核抗原（PCNA）染色，并进行高铁二胺-阿尔辛蓝染色。通过反常刀豆球蛋白A和半乳糖氧化酶-席夫反应对GA细胞的胃型或肠型表型进行组织化学评估。
在A组中，以下情况更为常见；重度发育异常（77.8%对0%，P < 0.001）、绒毛结构（66.7%对9.1%，P < 0.05）、硫酸黏蛋白分泌（88.9%对39.4%，P < 0.05）和混合胃-肠表型（77.8%对9.1%，P < 0.001）。A组中癌的发生与p53表达增加和PCNA标记指数呈正相关。所有腺瘤c-erbB-2均为阴性，但9例癌中有4例呈阳性反应。
GA的黏蛋白组织化学在评估后续癌变可能性方面可能具有一定价值。c-erbB-2、bcl-2、CA 19-9和CEA的免疫表达价值有限。与p53不同，c-erbB-2的免疫表达是GA恶性转化中的晚期事件。
