| 摘要: |
| 目的 探讨上皮细胞黏附分子（EPCAM）在胃癌组织中的表达及其与胃癌浸润转移及预后的关系，以及EPCAM作为胃癌早期诊断、预后判断和治疗靶点的临床价值。方法 应用免疫组织化学法检测436 例胃癌组织及92例癌旁非肿瘤胃黏膜组织中EPCAM 的表达情况，分析并探讨EPCAM 的表达与临床病理参数及预后的关系。结果 在92 例非肿瘤胃黏膜组织中，50例（54.3%）EPCAM 蛋白为阴性表达，42例（45.7%）呈弱阳性表达。在436 例胃癌组织中，EPCAM 蛋白高表达179 例（41.1%），低表达257 例（58.9%），主要在细胞包膜表达。EPCAM 蛋白的表达强度与肿瘤部位、肿瘤大小、Lauren 分型、浸润深度、淋巴结分期、TNM 分期、淋巴结转移和远处转移密切相关（均P＜0.01），而与患者性别、分化程度、组织学类型无关（均P ＞0.05）。EPCAM 高表达患者的5 年生存率（57.2%）明显低于EPCAM 低表达胃癌患者的5 年生存率（17.3%，P＜0.05）。I、II 和III 期EPCAM高表达胃癌患者的5年生存率明显低于EPCAM 低表达患者的5年生存率（P＜0.05）；IV 期EPCAM 高表达和低表达胃癌患者的5年生存率无统计学差异。EPCAM 表达、远处转移和TNM 分期（均P＜0.05）是胃癌的独立预后因素。结论 EPCAM 在胃癌中高表达，且其表达与淋巴结转移、远处转移、肿瘤的TNM 分期显著相关，提示EPCAM 可以作为胃癌的早期诊断的筛查指标以及治疗的靶点之一。 |
| 关键词: 胃癌 上皮细胞黏附分子 侵袭 转移 预后 |
| DOI： |
| 分类号: |
| 基金项目:浙江省科技计划项目 |
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| Expression of EPCAM correlated with invasion, metastasis and poor prognosis in patients with gastric cancer |
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HE Qiwen, YE Zaituan, XU Ji, ZHAO Zhongsheng, WANG Yuanyu
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Zhejiang People’s Hospital
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| Abstract: |
| Objective To investigate the clinical significance of EPCAM expression in gastric cancer. Methods The expression of EPCAMwas detected by immunohistochemistry (SP-9000) in 436 tissue samples of gastric cancer and 92 samples of non-cancerous gastric tissue. Results Low levels of EPCAM protein were detected in 42 of 92 (45.7%) non-tumor mucosa samples. High expression of EPCAMprotein was detected in 179(41.1%) gastric cancer samples, EPCAMwas localized mainly in the cytoplasmof primary cancer. The expression of EPCAMwas correlated with age, tumor location, tumor size, Lauren's classification, depth of invasion, distant metastases, regional lymph node stage and TNM stage (P＜0.05). EPCAM expression was not correlated with sex, differentiation or histological classification (P＞0.05). In stage I, II and III tumors, the 5-year survival rate in patients with high expression of EPCAMwas significantly lower than that in patients with low expression (P＜0.05). In stage IV tumors, the expression of EPCAM was not correlated with the 5-year survival rate (P＞0.05). Cox regression analysis revealed that lymph node and distant metastases(P＜0.05), TNMstage (P＜0.05) and expression of EPCAM (P＜0.05) were independent prognostic factors in patients with gastric carcinoma. Conclusion Expression of EPCAM in gastric cancer is associated significantly with lymph node and distant metastases, and poor prognosis, which indicates that EPCAM may be a useful marker for predicting the development, progression and metastasis of gastric cancer. |
| Key words: Gastric carcinoma EPCAM Invasion Metastasis Prognosis |
