Noguchi Y, Tsuburaya A, Makino T, Fukuzawa K, Nomura K, Yoshikawa T, Imada T, Amano T, Matsumoto A
Yokohama City University School of Medicine, First Department of Surgery, Japan.
Int Surg. 1993 Apr-Jun;78(2):107-11.
This study was conducted to see whether the accuracy in predicting liver metastases in gastric cancer patients increased when DNA aneuploidy and c-erbB-2 gene products were analyzed besides other clinicopathologic features. Aneuploidy was observed in 32 out of 74 tumors (43%); these included 62% of those tumors in patients with liver metastases, 43% of those with peritoneal dissemination and 26% of those in the 5-year survival group. Aneuploidy was positively correlated with the prognosis and degree of blood vessel invasion but not with lymph node metastases or lymphatic permeation. Positive staining for the c-erbB-2 gene product was detected in 19 out of 89 tumors (21%). This staining was not related to any of the clinicopathologic features examined. Multivariate analysis revealed that the degree of blood vessel invasion was the factor that most strongly correlated with liver metastases. The prognostic value of aneuploidy was significant (p < 0.05) but much smaller than that of blood vessel invasion (p < 0.0001), interstitial tissue reaction (p = 0.02), Borrmann type classification (p = 0.03). Analyses of DNA aneuploidy and c-erbB-2 gene expression in the primary tumor of gastric carcinoma to improve the accuracy of predicting liver metastasis seem to be of limited clinical value at present.
本研究旨在探讨除其他临床病理特征外,分析DNA非整倍体和c-erbB-2基因产物时,胃癌患者肝转移预测的准确性是否会提高。74例肿瘤中有32例(43%)观察到非整倍体;其中肝转移患者的肿瘤中有62%,腹膜播散患者的肿瘤中有43%,5年生存组患者的肿瘤中有26%。非整倍体与预后及血管侵犯程度呈正相关,但与淋巴结转移或淋巴管浸润无关。89例肿瘤中有19例(21%)检测到c-erbB-2基因产物阳性染色。这种染色与所检查的任何临床病理特征均无关。多因素分析显示,血管侵犯程度是与肝转移最密切相关的因素。非整倍体的预后价值显著(p < 0.05),但远小于血管侵犯(p < 0.0001)、间质组织反应(p = 0.02)、Borrmann分型(p = 0.03)。目前,分析胃癌原发肿瘤中的DNA非整倍体和c-erbB-2基因表达以提高肝转移预测准确性的临床价值似乎有限。