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目的 :探讨 CD4 4 v6和上皮钙粘素 (E- cd)在胃腺癌及淋巴结转移灶中的表达及其意义。方法 :应用免疫组化 SABC法检测 2 0例正常胃粘膜 ,2 0例异形增生 ,185例胃癌原发灶及 10 9例淋巴结转移灶中 CD4 4 v6和 E- cd表达。结果 :CD4 4 v6和 E- cd在异型增生、胃癌原发灶及淋巴结转移灶中阳性表达率分别为 2 0 .0 0 % (4/ 2 0 )、66.4 9% (12 3 / 185 )和87.18% (10 2 / 10 8)以及 85 .0 0 % (17/ 2 0 )、5 2 .97% (98/ 185 )和 2 6.5 0 % (3 1/ 117)。三者之间有显著差异 (P<0 .0 1)。CD4 4 v6表达率与胃癌生长方式、组织学类型、血管淋巴管内浸润及 TNM分期无关。 E- cd阳性表达与胃癌生长方式、组织学类型及 TNM分期显著相关。早期肠型胃癌 CD4 4 v6阳性表达率显著高于弥漫型 (P<0 .0 5 ) ,在进展期胃癌则无显著差异。E- cd的阳性表达率下降主要见于弥漫型胃癌。结论 :CD4 4 v6和 E- cd阳性表达同胃癌分化及生物学行为密切相关 ,是预测其侵袭转移有价值的指标。同时 ,此结果也支持胃癌两种不同起源的假说。
Objective: To investigate the expression and significance of CD4 4 v6 and E-cadherin in gastric adenocarcinoma and lymph node metastasis. Methods: Immunohistochemical SABC method was used to detect the expression of CD4 4 v6 and E-cadherin in 20 normal gastric mucosa, 20 dysplasia, 185 primary gastric cancer and 109 metastatic lymph nodes. Results: The positive rates of CD4 4 v6 and E-cd in dysplasia, primary gastric cancer and lymph node metastasis were 20.0% (4/20), 66.4 9% (12 3/185) and 87.18% (10 2/108) and 85.0% (17/20), 52.97% (98/185) and 26.5% (31/117), respectively. There was a significant difference between the three (P <0.01). The expression of CD4 4 v6 was not related to the growth pattern of gastric cancer, histological type, lymphatic vessel invasion and TNM staging. The positive expression of E-cd was significantly associated with the growth pattern, histological type and TNM stage of gastric cancer. The positive rate of CD4 4 v6 in early stage intestinal type gastric cancer was significantly higher than that in diffuse type (P <0.05), while there was no significant difference in advanced gastric cancer. E-cd positive expression rate decreased mainly seen in diffuse gastric cancer. Conclusion: The positive expression of CD4 4 v6 and E-cd is closely related to the differentiation and biological behavior of gastric cancer, which is a valuable index for predicting the invasion and metastasis of gastric cancer. At the same time, this result supports the hypothesis of two different origins of gastric cancer.