Matturri L, Biondo B, Cazzullo A, Colombo B, Giordano F, Guarino M, Pallotti F, Turconi P, Lavezzi A M
Institute of Pathology, University of Milan, IRCCS, Opedale Maggiore di Milano, Italy.
Anticancer Res. 1998 Jul-Aug;18(4B):2819-25.
The different clinical evolution of gastric adenocarcinomas with the same clinico-pathologic characteristics prompted the authors to investigate the prognostic significance of different biological markers.
One hundred twenty-six preoperative cancer gastric biopsies, selected according the stage evaluated after following gastrectomy, were examined for DNA content by means the static cytometry, proliferating cell nuclear antigen (PCNA), p53 mutation, apoptosis by immunohistochemistry and karyotype using fluorescence in situ hybridization (FISH) techniques.
The gastric cancers, ail belonging at stage III, were adenocarcinomas histologically typed as: 26 well differentiated (G1), 45 moderately differentiated (G2), 43 poorly differentiated (G3) and 12 of undifferentiated type with signet-ring cells. The tumours showed a prevalence of diploidy (68%), a mean PCNA-LI of 4.8%, trisomy of chromosome 7 in 40% of the cases, low presence of apoptosis (30%) and p53 mutation (17%). Only apoptosis was significantly correlated to histological diagnosis (p = 0.009). A multivariate analysis showed that the DNA content and PCNA-LI were the only independent prognostic markers for survival (p = 0.005 and p = 0.0002 respectively).
The evaluation of these two biological variables, especially of the PCNA index, on gastric cancer biopsies may be useful in predicting the aggressiveness of each tumor and in identifying patients in need of additional perioperative therapies.
具有相同临床病理特征的胃腺癌呈现出不同的临床进展，这促使作者研究不同生物标志物的预后意义。
根据胃切除术后评估的分期选择126例术前胃癌活检标本，采用静态细胞术检测DNA含量，通过免疫组织化学检测增殖细胞核抗原（PCNA）、p53突变、凋亡情况，并运用荧光原位杂交（FISH）技术检测核型。
这些胃癌均为III期，组织学类型为腺癌：26例高分化（G1），45例中分化（G2），43例低分化（G3），12例为伴有印戒细胞的未分化型。肿瘤显示二倍体占优势（68%），平均PCNA-LI为4.8%，40%的病例存在7号染色体三体，凋亡发生率低（30%），p53突变率为17%。只有凋亡与组织学诊断显著相关（p = 0.009）。多因素分析表明，DNA含量和PCNA-LI是仅有的独立生存预后标志物（分别为p = 0.005和p = 0.0002）。
对胃癌活检标本评估这两个生物变量，尤其是PCNA指数，可能有助于预测每个肿瘤的侵袭性，并识别需要额外围手术期治疗的患者。
