Okuyama T, Maehara Y, Kakeji Y, Tsuijitani S, Korenaga D, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Cancer. 1998 Apr 15;82(8):1468-75. doi: 10.1002/(sici)1097-0142(19980415)82:8<1468::aid-cncr6>3.0.co;2-5.
Expression of changes in cell surface glycoprotein may correlate with the malignant potential and development of gastric carcinoma. Immunologic defense mechanisms of the host against the tumor can be effective in preventing the development of gastric carcinoma. The authors studied the effects of immunologic defense of the host against the tumor, using infiltration of S-100 protein positive dendritic cells (DC) as a marker. In cases with or without changes in the surface glycoprotein of tumor cells, determinations were made by binding of Helix pomatia agglutinin (HPA).
Paraffin blocks of 123 gastric carcinoma specimens were prepared for immunohistochemical staining with the antibody against HPA and S-100 protein. Clinicopathologic factors and patient prognosis were examined for each indicator.
Patients with HPA positive tumors had a more aggressive character in several important prognostic aspects and poorer 5-year survival rates compared with patients with HPA negative tumors. The degree of infiltration of DC had no particular correlation with pathologic factors, and there was no significant difference between the prognosis of patients with slight and marked DC infiltration. In the HPA negative patients there was no significant difference in the 5-year survival rates between patients with slight and marked DC infiltration; however, in the HPA positive patients the 5-year survival rates of patients with marked infiltration of DC were higher. Further investigation showed that patients with marked DC infiltration had better 5-year survival rates than patients with slight DC infiltration, especially in patients with HPA positive and histologically advanced disease.
Patients with a higher immunologic defense against cancer cells, as indicated by marked infiltration of DC, had a better prognosis in cases of gastric carcinomas of highly malignant potential, as indicated by a positive HPA.
细胞表面糖蛋白变化的表达可能与胃癌的恶性潜能及发展相关。宿主针对肿瘤的免疫防御机制可有效预防胃癌的发生。作者以S-100蛋白阳性树突状细胞（DC）浸润为标志物，研究宿主针对肿瘤的免疫防御作用。对于肿瘤细胞表面糖蛋白有无变化的病例，通过锥蜗牛凝集素（HPA）结合进行测定。
制备123例胃癌标本的石蜡块，用抗HPA和S-100蛋白抗体进行免疫组化染色。对每个指标检查临床病理因素及患者预后。
与HPA阴性肿瘤患者相比，HPA阳性肿瘤患者在几个重要的预后方面具有更强的侵袭性，5年生存率更低。DC浸润程度与病理因素无特定相关性，DC轻度浸润和重度浸润患者的预后无显著差异。在HPA阴性患者中，DC轻度浸润和重度浸润患者的5年生存率无显著差异；然而，在HPA阳性患者中，DC重度浸润患者的5年生存率更高。进一步研究表明，DC重度浸润患者的5年生存率高于DC轻度浸润患者，尤其是在HPA阳性且组织学分期较晚的疾病患者中。
以DC重度浸润为指标，对癌细胞具有较高免疫防御能力的患者，在具有高恶性潜能的胃癌病例中（以HPA阳性为指标），预后较好。
