胃印戒细胞癌与黏液腺癌生物学特征及分子病理学机制的比较研究  

Pathological behaviors and molecular mechanisms of signet-ring cell carcinoma and mucinous adenocarcinoma of stomach: a comparative study

作　　者：杨琳[1] 王艳萍[1] 吴东瑛[1] 张素敏[1] 李锦毅[1] 张荫昌[1] 辛彦[1] 

机构地区：[1]中国医科大学肿瘤研究所第四研究室,辽宁省沈阳市110001

出　　处：《世界华人消化杂志》2002年第5期516-524,共9页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助课题;NO.39270300和NO.39370772;教育部跨世纪优秀人才培养计划基金资助课题;教技函[1999]2号

摘　　要：目的:以胃癌组织学生长方式分型和癌细胞功能分化表型研究为基础,从形态、机能与蛋白分子水平相结合的层次,探讨胃印戒细胞癌和黏液腺癌浸润转移的生物学规律及相关分子病理学机制。 方法:本系列研究标本全部取自中国医科大学肿瘤研究所存档石蜡标本和冰冻标本。在病理形态学观察的基础上,采用酶组织化学、黏液组织化学和免疫组织化学、流式细胞技术(FCM)结合分子生物学方法检测并比较上述两型胃癌相关基因编码蛋白表达、癌细胞DNA倍体、增生细胞动力学,微卫星不稳定性和杂合性丢失等分子生物学特征。 结果:近40a研究发现,胃印戒细胞癌好发于中青年女性,组织学上倾向于弥漫性生长,以吸收-黏液分泌功能双向分化(AMPFDT)为主,生长依赖雌激素,好发卵巢和子宫颈转移。胃黏液腺癌多见于50岁以上男性,倾向于团块状或巢状生长,功能分化上表现为AMPFDT型和黏液分泌功能分化型(MSFDT)两种类型,生长不依赖雌激素,以腹膜广泛浸润生长为主要特点,层粘蛋白及其受体和Ⅳ型胶原、CD_(44)v_6、PTEN蛋白表达显著高于胃印戒细胞癌。两型胃癌酸性磷酸酶(ACP)和血管内皮生长因子(VEGF)无显著差异。 结论:胃印戒细胞癌和黏液腺癌虽都以旺盛的黏液分泌能力为主要特征,但他们在病理形态、超微结构、生长浸润方式、功能分化和基?AIM:To elucidate and compare the distinctive pathobiological behaviors between signet ring-cell carcinoma (SRC) and mutinous adenocarcinoma of the stomach.METHODS: Based on the histological growth patterns and cell-function differentiation classifications of stomach carcinoma, we conducted series of comparative studies. All paraffin-embedded and frozen blocks were from the files of Cancer Institute of China Medical University. On the basis of histopathological observation, the authors applied enzymic and mucinous histochemistry, immunohistochemistry, flow cytometry ( FCM) combinined with molecular biological methods to compare these two categories of gastric cancers in the DNA ploidy, proliferating kinetics, and the expression of laminin (LN) and its receptors (LR), collagen-Ⅳ, CD44v6 and PTEN proteins.RESULTS: SRC of the stomach was commonly seen in females less than 45 years, and had a tendency to diffuse growth and metastasis into ovary or uterine cervix. The majority of SRC were absorptive and mucin - producing double functional differentiation type ( AMPFDT), which growth relied on estrogen. Meanwhile, stomach mucinous adenocarcinoma were mostly seen in males over 50 years, and tended to massive growth or nest growth and peritoneal - intensive infiltration, showing two categories of cell-function differentiation types: AMPFDT and mucin-secreting functional differentiation type (MSFDT). Expression of LN, LR, collagen-Ⅳ, CD44v6 and PTEN protein was significantly higher in mucinous adenocarcinoma than that in signet ring cell carcinoma.CONCLUSION: SRC and mucinous adenocarcinoma are significantly different in morphology, ultrastructure, cell-functional differentiation and protein expression, indicating different mechanisms in carcinogenesis Combined analyses of histological growth patterns, cell-function differentiation and molecular biological typing can be significant in diagnosis and prognostic assessment for SRC and mucinous adenocarcinoma of the stomach.

关 键 词：胃印戒细胞癌 黏液腺癌 生物学特征 分子病理学机制 比较研究 

分 类 号：R735.2[医药卫生—肿瘤]