上皮细胞黏附分子在胃癌组织中的表达及其与预后的关系  

Expression of EPCAM correlated with invasion,metastasis and poor prognosis in patients with gastric cancer

作　　者：何琦文[1,2] 叶再元[1] 徐继[1] 赵仲生[3] 王元宇[1] 

机构地区：[1]浙江省人民医院胃肠外科,杭州310014 [2]浙江中医药大学 [3]浙江省人民医院病理科,杭州310014

出　　处：《浙江医学》2015年第6期443-446,I0001,共5页Zhejiang Medical Journal

基　　金：浙江省科技计划项目(2011C33009)

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。Objective To investigate the clinical significance of EPCAM expression in gastric cancer. Methods The expression of EPCAM was 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 EPCAM protein was detected in 179（41.1%） gastric cancer samples, EPCAM was localized mainly in the cytoplasm of primary cancer. The expression of EPCAM was 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 EPCAM was 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）, TNM stage （P〈0.05） and expression of EPCAM （P〈0.05） were independent prog- nostic 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.

关 键 词：胃癌 上皮细胞黏附分子 侵袭 转移 预后 

分 类 号：R735.2[医药卫生—肿瘤]