Takamura H, Yonemura Y, Hirono Y, Ninomiya I, Sahara H, Tsugawa K, Matsumoto H, Sugiyama K, Fujimura T, Nishimura G
Dept. of Surgery II, School of Medicine, Kanazawa University.
Gan To Kagaku Ryoho. 1993 Apr;20(6):788-95.
One-hundred and sixty-four patients with gastric carcinomas, who underwent gastrectomy during 1979-1985, were studied. Sixty-five of these cases were early gastric carcinomas, and the others were advanced gastric carcinomas, and the others were advanced gastric carcinomas. The nuclear DNA contents were measured by cytofluorometry, and immunohistochemical study on the expression of c-erbB-2 protein was performed using a monoclonal antibody against the c-erbB-2 oncogene product. Furthermore, immunohistochemical detection of proliferating cell nuclear antigen (PCNA) was performed using a monoclonal antibody against the PCNA. The rates of positive invasion beyond submucosal layer, lymphatic invasion, and vascular invasion in aneuploid cases were significantly higher than those in diploid ones, and the patients with aneuploid tumor had a significantly worse prognosis than those with diploid tumor. The rates of positive lymph node metastases and invasion beyond submucosal layer in the group with positive staining of the c-erbB-2 protein was significantly higher than in the negative group, and the group with positive staining for c-erbB-2 had a significantly worse prognosis than the negative one. PCNA indices showed a significant correlation with lymph node metastasis, and the group with higher PCNA indices had a worse prognosis. The patients with tumor showing both aneuploid and positive staining for c-erbB-2 protein, had the worst prognosis. There is a relationship between c-erbB-2 tissue status and PCNA indices, but no correlations were found among c-erbB-2 tissue status, PCNA indices and DNA contents. From these results, it can be concluded that DNA ploidy, c-erbB-2 protein, and PCNA may reflect the malignant potential of gastric carcinoma.
对1979年至1985年间接受胃切除术的164例胃癌患者进行了研究。其中65例为早期胃癌,其余为进展期胃癌。采用细胞荧光测定法测量细胞核DNA含量,并用抗c-erbB-2癌基因产物的单克隆抗体对c-erbB-2蛋白的表达进行免疫组织化学研究。此外,用抗增殖细胞核抗原(PCNA)的单克隆抗体进行PCNA的免疫组织化学检测。非整倍体病例中黏膜下层以外阳性浸润率、淋巴浸润率和血管浸润率显著高于二倍体病例,非整倍体肿瘤患者的预后明显比二倍体肿瘤患者差。c-erbB-2蛋白染色阳性组的阳性淋巴结转移率和黏膜下层以外浸润率显著高于阴性组,c-erbB-2染色阳性组的预后明显比阴性组差。PCNA指数与淋巴结转移显著相关,PCNA指数较高的组预后较差。肿瘤同时显示非整倍体和c-erbB-2蛋白染色阳性的患者预后最差。c-erbB-2组织状态与PCNA指数之间存在关系,但在c-erbB-2组织状态、PCNA指数和DNA含量之间未发现相关性。从这些结果可以得出结论,DNA倍体、c-erbB-2蛋白和PCNA可能反映胃癌的恶性潜能。