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目的探讨上皮型钙黏附素(E-cadherin,E-cad)在肠型和弥漫型胃癌中的表达情况及其对疾病发生、治疗和预后评估的意义。方法采用免疫组化S-P法对30例正常胃或胃炎粘膜上皮组织、30例散发性肠型胃癌组织和30例遗传性弥漫型胃癌组织中E-cad表达情况进行研究。结果正常或胃炎上皮组织中E-cad全部为阳性表达,表达均匀,散发性肠型胃癌和遗传性弥漫型胃癌组织中E-cad表达均明显减低(P<0.05),表达阳性率分别为63%(19/30)和23%(7/30)。散发性肠型胃癌中E-cad的表达与临床分期相关(P<0.05),遗传性弥漫型胃癌中E-cad的表达与疾病临床分期无关(P>0.05)。结论散发性肠型胃癌E-cad表达降低,呈断续性或者胞浆异位性表达,并与临床分期相关,可能对肠型胃癌的预后评估和治疗具有指导意义。E-cad在遗传性弥漫型胃癌中表达降低更为明显,大部分癌组织中呈现表达缺失,但与分期无关,E-cad表达缺失在遗传性弥漫型胃癌发病的早期可能具有重要作用。
Objective To investigate the expression of E-cadherin (E-cad) in intestinal type and diffuse type gastric carcinoma and its significance in the occurrence, treatment and prognosis of the disease. Methods The expression of E-cadherin in 30 cases of normal gastric or gastritis mucosal epithelium, 30 cases of sporadic intestinal type gastric cancer and 30 cases of hereditary diffuse type gastric carcinoma were studied by immunohistochemical S-P method. Results The expression of E-cadherin in normal or gastritis epithelial tissues was all positive and the expression was even. The expression of E-cad was significantly lower in sporadic intestinal gastric cancer and hereditary diffuse gastric cancer (P <0.05), and the positive rates were 63 % (19/30) and 23% (7/30). The expression of E-cad in sporadic gastric cancer was correlated with clinical stage (P <0.05). The expression of E-cadherin in diffuse gastric cancer was not related to clinical stage (P> 0.05). Conclusions The expression of E-cadherin in sporadic intestinal type gastric cancer is decreased, expressed intermittently or cytoplasm, and is correlated with clinical stage, which may be of guiding significance in the prognosis evaluation and treatment of intestinal type gastric cancer. The expression of E-cad in diffusely-typed gastric cancer is more obvious, and the expression of E-cad in most of cancers is absent. However, the expression of E-cad is not related to the stage. E-cad may play an important role in the early stage of hereditary diffuse type gastric cancer.