唾液酸Tn抗原表达与晚期胃癌患者的预后相关。

Sialosyl Tn antigen expression is associated with the prognosis of patients with advanced gastric cancer.

作者信息

Yamada T, Watanabe A, Yamada Y, Shino Y, Tanase M, Yamashita J, Miwa T, Nakano H

机构信息

First Department of Surgery, Nara Medical University, Japan.

出版信息

Cancer. 1995 Nov 1;76(9):1529-36. doi: 10.1002/1097-0142(19951101)76:9<1529::aid-cncr2820760905>3.0.co;2-g.

DOI:10.1002/1097-0142(19951101)76:9<1529::aid-cncr2820760905>3.0.co;2-g

PMID:8635053

Abstract

BACKGROUND

Several studies have revealed a correlation between sialosyl Tn antigen (STN) and certain clinicopathologic features of various cancers, and that STN is an independent prognostic factor. However, the clinical significance of the expression of STN in gastric cancer has not been reported. Thus, the purpose of this study was to evaluate immunohistochemically the clinical significance of expression of STN in gastric cancer.

METHODS

The expression of STN in surgically resected specimens of human gastric cancer was evaluated immunohistochemically using a monoclonal antibody (TKH-2), in 60 patients whose serum STN levels were measured and in 54 patients with advanced cancer who had been followed for more than 5 years after gastrectomy. The correlations between the level of STN expression and clinicopathologic factors were analyzed. The staining intensity was graded as follows: (-), less than 5% of the cancer cells expressed STN; (+), 5-50%; (++), more than 50%.

RESULTS

Sialosyl TN antigen staining was detected mainly on the cell membrane, in the cytoplasm, and in the luminal contents, and 57.2% of the 60 specimens expressed STN, whereas the corresponding value for positive serum levels was 15%. A higher percentage of advanced tumors expressed STN than did the early cases, but the difference was not statistically significant. All cases with strong staining, the (++) cases, were advanced cases either with lymph node metastases or with cancer invading in or beyond the muscle layer proper. The expression of STN appeared to be related to the clinical stage, the extent of cancer invasion, and the presence of lymph node metastases. Sialosyl TN antigen was detected in the serum in less than 6% of the patients whose tumors were (-) or (+) for STN expression, and in 86.7% of the patients whose tumors expressed high levels of STN (++). The estimated 5-year survival in advanced cases (Stage III) was significantly better in those with negative STN expression than in those with positive STN expression (P < 0.01).

CONCLUSIONS

These results suggest that STN may be a useful marker associated with the prognosis of patients with advanced gastric cancer.

摘要

背景

多项研究揭示了唾液酸化Tn抗原（STN）与多种癌症的某些临床病理特征之间存在相关性，且STN是一个独立的预后因素。然而，STN在胃癌中表达的临床意义尚未见报道。因此，本研究旨在通过免疫组织化学方法评估STN在胃癌中表达的临床意义。

方法

使用单克隆抗体（TKH-2）通过免疫组织化学方法评估60例测量血清STN水平的患者以及54例胃癌根治术后随访超过5年的晚期癌症患者手术切除的人胃癌标本中STN的表达。分析STN表达水平与临床病理因素之间的相关性。染色强度分级如下：（-），少于5%的癌细胞表达STN；（+），5%-50%；（++），超过50%。

结果

唾液酸化TN抗原染色主要在细胞膜、细胞质和管腔内容物中检测到，60例标本中有57.2%表达STN，而血清阳性水平的相应值为15%。晚期肿瘤表达STN的比例高于早期病例，但差异无统计学意义。所有强染色病例，即（++）病例，均为伴有淋巴结转移或癌浸润至固有肌层或超出固有肌层的晚期病例。STN的表达似乎与临床分期、癌症浸润范围和淋巴结转移的存在有关。肿瘤STN表达为（-）或（+）的患者中，血清中检测到唾液酸化TN抗原的比例低于6%，而肿瘤STN高表达（++）的患者中这一比例为86.7%。晚期病例（III期）中，STN表达阴性者的估计5年生存率显著高于STN表达阳性者（P<0.01）。