Nakamori S, Kameyama M, Imaoka S, Furukawa H, Ishikawa O, Sasaki Y, Kabuto T, Iwanaga T, Matsushita Y, Irimura T
Department of Surgery, Center for Adult Diseases, Osaka, Japan.
Cancer Res. 1993 Aug 1;53(15):3632-7.
We have previously shown that sialyl Lewisx antigen (sLex) (NeuAc alpha 2-3Gal beta 1-4(Fuc alpha 1-3)GlcNAC-R) has an important functional role in defining the invasion and metastasis of human colorectal carcinoma. The results were derived from the clinical specimens obtained at surgery or experimental metastasis of human colon carcinoma variant expressing different levels of sLex in nude mice. In the present study, we immunohistochemically examined 132 human colorectal carcinomas for the expression of sLex to investigate whether this antigen expression could serve as a prognostic parameter. The tumors were divided into two groups: sLex positive and sLex negative. The incidence of sLex positive was correlated with the depth of tumor invasion, the presence of the lymph node metastasis, lymphatic invasion, and the disease stage. The difference was statistically significant (P = 0.0026; P = 0.0002; P = 0.003; P = 0.0013; respectively). Based on the data on 114 patients who underwent curative resections, incidence of the disease recurrence was assessed. The sLex-positive patients had higher incidence of recurrence in distant organs, especially in the liver, than that of the sLex-negative patients. The 5-year disease free survival rates of sLex-positive and -negative patients were 57.7 and 89.1%, respectively (P = 0.0002). The difference of 5-year overall survival rates between the two were also significant (sLex positive, 58.3%; sLex negative, 93.0%: P < 0.0001). By Cox multivariate analysis, sLex expression levels remained the best discriminant of disease-free survival (P = 0.035) and overall survival (P = 0.0081). These results suggest that increased expression of sLex is correlated with the extent of malignancy and high incidence of recurrence and consequently with survival of colorectal carcinoma patients. Thus sLex may prove to be a potent marker of recurrence in colorectal carcinoma patients.
我们之前已经表明，唾液酸化路易斯x抗原（sLex）（NeuAcα2-3Galβ1-4（Fucα1-3）GlcNAC-R）在界定人类结直肠癌的侵袭和转移方面具有重要的功能作用。这些结果源自于在手术时获取的临床标本，或源自于在裸鼠中表达不同水平sLex的人类结肠癌变体的实验性转移。在本研究中，我们采用免疫组织化学方法检测了132例人类结直肠癌中sLex的表达情况，以研究该抗原表达是否可作为一个预后参数。肿瘤被分为两组：sLex阳性和sLex阴性。sLex阳性的发生率与肿瘤侵袭深度、淋巴结转移情况、淋巴管侵袭以及疾病分期相关。差异具有统计学意义（分别为P = 0.0026；P = 0.0002；P = 0.003；P = 0.0013）。基于114例行根治性切除术患者的数据，评估了疾病复发的发生率。sLex阳性患者远处器官尤其是肝脏的复发发生率高于sLex阴性患者。sLex阳性和阴性患者的5年无病生存率分别为57.7%和89.1%（P = 0.0002）。两组之间5年总生存率的差异也具有显著性（sLex阳性为58.3%；sLex阴性为93.0%：P < 0.0001）。通过Cox多因素分析，sLex表达水平仍然是无病生存（P = 0.035）和总生存（P = 0.0081）的最佳判别指标。这些结果表明，sLex表达增加与恶性程度、高复发率相关，进而与结直肠癌患者的生存相关。因此，sLex可能被证明是结直肠癌患者复发的一个有效标志物。
