de Manzoni G, Guglielmi A, Di Leo A, Tomezzoli A, Laterza E, Bonfiglio M, Biolo S, Tedesco P, Borzellino G
Istituto di Semeiotica Chirurgica, Universitá degli Studi di Verona.
G Chir. 1998 Aug-Sep;19(8-9):323-8.
The expression of 67-KDa laminin receptor (LR) was investigated in a group of 75 patients who underwent curative gastrectomy for advanced gastric cancer, with special reference to the possible role in the tumor progression and in the overall survival. In 56 out of these 75 patients also the prognostic significance of proliferative activity was investigated using the monoclonal antibody Ki-67. The tumor LR expression and the Ki-67 labeling index (Ki-67 LI) were immunohistochemically determined in paraffin-embedded sections using the avidin-biotin immunoperoxidase method. The cumulative 5-years survival rate was 75.1% for patients without expression of LR, 52.6% for those with positive LR expression. Significant association between LR expression and depth of tumor invasion (p = 0.022) was found. By univariate analysis the presence of laminin receptor seemed to be associated with an higher risk of death (RR1.73-95% C.I. 0.71-4.20), but this effect disappeared after controlling for depth of tumor invasion. There was no significant relationship between the Ki-67 LI and wall invasion (p = 0.80) or nodal status (p = 0.73). The cumulative 5-year survival rates (95% CI) were 61.0% (35.3-79.2) in patients with Ki-67 index < 10%, 52.4% (29.7-70.9) with Ki-67 index = 10%-40%, 52.9% (27.6-73.0) with Ki-67 index > 40% and the differences were not statistically significant (p = 0.93). Also in multivariate analysis the proliferative activity did not independently affect survival (p = 0.98). An interaction between Ki-67 index and age was found and Ki-67 index > 40% was significantly associated with a poor prognosis in patients over 70 years old old (p = 0.002). In conclusion, tumor expression of laminin receptor could be correlated with gastric cancer aggressiveness, however its prognostic significance is already provided by depth of tumor invasion. The proliferative activity, determined with the monoclonal antibody Ki-67, does not seems to influence the survival except in elderly patients (> or = 70 years old).
对75例行根治性胃癌切除术的进展期胃癌患者，研究了67-kDa层粘连蛋白受体（LR）的表达情况，特别关注其在肿瘤进展和总生存中的可能作用。在这75例患者中的56例中，还使用单克隆抗体Ki-67研究了增殖活性的预后意义。采用抗生物素蛋白-生物素免疫过氧化物酶法，对石蜡包埋切片进行免疫组织化学测定肿瘤LR表达和Ki-67标记指数（Ki-67 LI）。LR无表达患者的5年累积生存率为75.1%，LR表达阳性患者为52.6%。发现LR表达与肿瘤浸润深度之间存在显著相关性（p = 0.022）。单因素分析显示，层粘连蛋白受体的存在似乎与较高的死亡风险相关（RR 1.73-95% C.I. 0.71-4.20），但在控制肿瘤浸润深度后，这种效应消失。Ki-67 LI与壁层浸润（p = 0.80）或淋巴结状态（p = 0.73）之间无显著关系。Ki-67指数<10%的患者5年累积生存率（95% CI）为61.0%（35.3-79.2），Ki-67指数=10%-40%的患者为52.4%（29.7-70.9），Ki-67指数>40%的患者为52.9%（27.6-73.0），差异无统计学意义（p = 0.93）。多因素分析中，增殖活性也未独立影响生存（p = 0.98）。发现Ki-67指数与年龄之间存在交互作用，Ki-67指数>40%与70岁以上患者的不良预后显著相关（p = 0.002）。总之，层粘连蛋白受体的肿瘤表达可能与胃癌侵袭性相关，但其预后意义已由肿瘤浸润深度所决定。用单克隆抗体Ki-67测定的增殖活性似乎不影响生存，除非是老年患者（≥70岁）。
