CAJ | 학술논문

目的探讨上皮细胞黏附分子E-钙黏附素(E-CD)及链接素-α(α-CA)在胃癌的表达及其与胃癌生物学行为的关系。方法采用免疫组化技术(ABC法)对70例手术切除新鲜胃癌组织进行了E-CD及α-CA表达情况的检测，每例均行腹腔脱落癌细胞和系统病理学检查。结果胃癌组织E-CD及α-CA表达阳性率分别为38.6%和28.6%。在侵袭型、未分化型、弥漫状生长、侵透浆膜(T3/T4)、淋巴结转移阳性及Ⅲ、Ⅳ期胃癌中，E-CD及α-CA表达显著减弱(P＜0.025～0.005)。在淋巴结多数转移(＞5个)，转移度＞50%及转移至Ⅱ站以远的胃癌中，E-CD及α-CA表达亦明显减弱，且 α-CA比E-CD降低更明显(P＜0.05～0.005)。E-CD(+)/α-CA(－)及E-CD(－)/α-CA(－)组淋巴结转移率和脱落癌细胞阳性率均高于E-CD(+)/α-CA(+)组(P＜0.05～0.005)，但E-CD(+)/α-CA(－)组肝转移率高于E-CD(+)/α-CA(+)及E-CD(－)/α-CA(－)组(P＜0.005)。结论 E-CD/α-CA联合检测对评估胃癌侵袭深度、淋巴结转移程度、肝转移、TNM分期及腹腔癌细胞脱落状态有较大意义，其中α-CA比E-CD表达更敏感。
목적탐토상피세포점부분자E-개점부소(E-CD)급련접소-α(α-CA)재위암적표체급기여위암생물학행위적관계。방법채용면역조화기술(ABC법)대70례수술절제신선위암조직진행료E-CD급α-CA표체정황적검측，매례균행복강탈락암세포화계통병이학검사。결과위암조직E-CD급α-CA표체양성솔분별위38.6%화28.6%。재침습형、미분화형、미만상생장、침투장막(T3/T4)、림파결전이양성급Ⅲ、Ⅳ기위암중，E-CD급α-CA표체현저감약(P＜0.025～0.005)。재림파결다수전이(＞5개)，전이도＞50%급전이지Ⅱ참이원적위암중，E-CD급α-CA표체역명현감약，차 α-CA비E-CD강저경명현(P＜0.05～0.005)。E-CD(+)/α-CA(－)급E-CD(－)/α-CA(－)조림파결전이솔화탈락암세포양성솔균고우E-CD(+)/α-CA(+)조(P＜0.05～0.005)，단E-CD(+)/α-CA(－)조간전이솔고우E-CD(+)/α-CA(+)급E-CD(－)/α-CA(－)조(P＜0.005)。결론 E-CD/α-CA연합검측대평고위암침습심도、림파결전이정도、간전이、TNM분기급복강암세포탈락상태유교대의의，기중α-CA비E-CD표체경민감。
Objective　To evaluate the expression of cell 　adhesion 　molecules 　E-cadherin (E-CD) and α-catenin (α-CA) in relation to biologic behavior of gastric cancer.　Methods　The level of E-CD and α-CA expression was examined in 70 cases of primary gastric cancer by immunohistochemical technique.　Results　The rate of E-CD and α-CA expression was significantly reduced in gastric cancer with more prominent malignant phenotype, such as tumor in stage III/IV with poor cell differentiation, invasion through serosa and lymph node (LN) metastasis.With the increase in the number and frequency of LN metastasis and its dissemination distal to second group LNs, the reduction in expression of the two adhesion molecules was increasingly significant. The frequency of LN metastasis and shed cancer cells in the peritoneum in patients with E-CD(-)/α-CA(-) and E-CD(+)/αCA(-) cancer were significantly higher than those in patients with E-CD(+)/α-CA(+) tumor. Liver metastasis was most frequent in all cases with E-CD(+)/α-CA(-) tumor.　Conclusion　Down regulation of E-CD and/or α-CA correlates with the malignant behavior of gastric cancer. Examination of E-CD and α-CA expression in primary gastric cancer helps evaluate its intensity of LN metastasis, TNM staging and prognosis.Q