Sakamoto H, Yonezawa S, Utsunomiya T, Tanaka S, Kim Y S, Sato E
Second Department of Pathology, Kagoshima University School of Medicine, Kagoshima-shi Medical Association Hospital, Kagoshima City, Japan.
Hum Pathol. 1997 Sep;28(9):1056-65. doi: 10.1016/s0046-8177(97)90059-9.
The striking differences in the histological features of gastric cancers in young and old adults have been thought to be related to differences in the biological behavior of these cancers. Recently, a new grading system (Goseki's classification) showed that the prognosis of the patient is particularly related to the mucin content of the carcinoma. In this study, we examined differences in mucin antigen expression in cancers from young and old adults and whether antigen expression is related to the clinical outcome. The expression of two mucin core proteins (DF3 antigen [MUC1 gene product] and MRP antigen [MUC2 gene product] and a mucin-type carbohydrate antigen [sialosyl-Tn; STn]) was examined immunohistochemically in gastric cancers from 69 young adults (30 to 39 years of age) and 110 old adults (80 to 89 years of age). The incidence rates of the three histological types (tubular adenocarcinoma, poorly differentiated adenocarcinoma, and signet-ring cell carcinoma) were different in the young and old adults. However, among the mucin antigens examined, only DF3 showed significantly higher frequency of expression in the old adults, and the difference was seen only in tubular adenocarcinomas (young, 43%; old, 68%) and poorly differentiated adenocarcinomas (young, 19%; old, 49%). In these two histological types, there was no difference in the frequency of MRP or STn expression between the young and old adults, although the old adults showed a high incidence of intestinal metaplasia that was positive for both antigens. Signet-ring cell carcinomas showed no significant difference in expression rates of the three antigens in young and old adults, but there were significantly higher expression rates in young patients for both MRP (young, 67%; old, 65%) and STn (young, 71%; old, 57%) and a lower rate of DF3 expression (young, 0%; old, 14%). In both young and old adults, the patients with DF3-positive carcinomas showed significantly poorer survival than those without DF3 expression, whereas there was not significant difference in the survival of the patient groups with positive and negative MRP or STn reactivity. In conclusion, the expression of DF3 was influenced by the age of patients and was related to the outcome. In contrast, MRP and STn expression was related more to the histological pattern of the tumor than to the age of the patient and did not correlate with the outcome.
年轻人和老年人胃癌的组织学特征存在显著差异，这被认为与这些癌症的生物学行为差异有关。最近，一种新的分级系统（五木分类法）表明，患者的预后尤其与癌组织中的黏液含量有关。在本研究中，我们检测了年轻人和老年人癌症中黏液抗原表达的差异，以及抗原表达是否与临床结果相关。通过免疫组织化学方法检测了69名年轻成年人（30至39岁）和110名老年成年人（80至89岁）胃癌中两种黏液核心蛋白（DF3抗原[MUC1基因产物]和MRP抗原[MUC2基因产物]）以及一种黏液型碳水化合物抗原（唾液酸化-Tn；STn）的表达。年轻人和老年人中三种组织学类型（管状腺癌、低分化腺癌和印戒细胞癌）的发生率不同。然而，在所检测的黏液抗原中，只有DF3在老年成年人中的表达频率显著更高，且这种差异仅见于管状腺癌（年轻人，43%；老年人，68%）和低分化腺癌（年轻人，19%；老年人，49%）。在这两种组织学类型中，年轻人和老年人之间MRP或STn的表达频率没有差异，尽管老年成年人中这两种抗原均呈阳性的肠化生发生率较高。印戒细胞癌在年轻人和老年人中三种抗原的表达率没有显著差异，但MRP（年轻人，67%；老年人，65%）和STn（年轻人，71%；老年人，57%）在年轻患者中的表达率显著更高，而DF3的表达率更低（年轻人，0%；老年人，14%）。在年轻人和老年人中，DF3阳性癌患者的生存率显著低于无DF3表达的患者，而MRP或STn反应性阳性和阴性的患者组生存率没有显著差异。总之，DF3的表达受患者年龄影响且与预后相关。相比之下，MRP和STn的表达更多地与肿瘤的组织学模式相关，而非患者年龄，且与预后无关。
