Maehara Y, Yamamoto M, Oda S, Baba H, Kusumoto T, Ohno S, Ichiyoshi Y, Sugimachi K
Department of Surgery II, Kyushu University Hospital Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Br J Cancer. 1996 Jan;73(1):83-7. doi: 10.1038/bjc.1996.15.
Direct evidence of tumour seeding in distant organs at the time of surgery for gastric cancer is not available. An immunocytochemical assay for epithelial cytokeratin protein may fill this gap since it is a feature of epithelial cells that would not normally be present in bone marrow. The bone marrow of 46 patients with primary gastric cancer was examined for tumour cells, using immunocytochemical techniques and antibody reacting with cytokeratin, a component of the intracytoplasmic network of intermediate filaments. The monoclonal antibody CK2 recognises a single cytokeratin polypeptide (human cytokeratin no. 18) commonly present in epithelial cells. The expression of tumour-suppressor genes p53 and RB for the primary lesion was also determined using the monoclonal antibodies PAb 1801 and 3H9 respectively, and the proliferating activity was determined by the Ki-67 antigen labelling index for MIB-1 antibody staining. Of these 46 patients, 15 (32.6%) presented with cytokeratin-positive cells at the time of primary surgery. The positive findings were related to the undifferentiated tissue type and to the prominent depth of invasion, but not to other clinicopathological factors. In 2 of 15 (13.3%) patients, the depth of invasion was limited to the mucosa. The metastatic potential to bone marrow did not relate to expressions of p53 and RB genes, or to the proliferating activity of MIB-1 staining for the primary lesion of gastric cancer. As tumour cells in bone marrow are indicative of the general disseminative capability of an individual tumour, this technique may be useful for identifying patients at high risk of metastasis from a gastric tumour.
在胃癌手术时，尚无远处器官肿瘤播散的直接证据。针对上皮细胞角蛋白的免疫细胞化学检测可能填补这一空白，因为上皮细胞的这一特性通常不会出现在骨髓中。利用免疫细胞化学技术和与细胞角蛋白（一种细胞质中间丝网络的组成成分）反应的抗体，对46例原发性胃癌患者的骨髓进行肿瘤细胞检测。单克隆抗体CK2识别上皮细胞中常见的一种单一细胞角蛋白多肽（人细胞角蛋白18号）。还分别使用单克隆抗体PAb 1801和3H9测定了原发性病变中肿瘤抑制基因p53和RB的表达，并通过MIB - 1抗体染色的Ki - 67抗原标记指数测定增殖活性。在这46例患者中，15例（32.6%）在初次手术时出现细胞角蛋白阳性细胞。阳性结果与未分化组织类型和显著的浸润深度有关，但与其他临床病理因素无关。在15例患者中的2例（13.3%），浸润深度仅限于黏膜层。骨髓转移潜能与p53和RB基因的表达或胃癌原发性病变的MIB - 1染色增殖活性无关。由于骨髓中的肿瘤细胞表明单个肿瘤的总体播散能力，该技术可能有助于识别胃癌转移高危患者。
