EBV相关性胃癌中CLDN18.2的表达及临床病理分析  

Expression of Claudin18.2 in gastric cancer and its clinical significance

作　　者：张蒙 琚璐 王瑞芬[1] 管雯斌[1] 孙也淇 王立峰[1] ZHANG Meng;JU Lu;WANG Ruifen;GUAN Wenbin;SUN Yeqi;WANG Lifeng(Department of Pathology,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China;Department of Pathology,the Second Xiangya Hospital of Central South University,Changsha 410011,China)

机构地区：[1]上海交通大学医学院附属新华医院病理科,上海200092 [2]中南大学湘雅二医院病理科,长沙410011

出　　处：《临床与实验病理学杂志》2024年第12期1268-1275,共8页Chinese Journal of Clinical and Experimental Pathology

基　　金：上海市卫生健康委员会面上项目(202340043)。

摘　　要：目的探讨Claudin18.2在EBV相关性胃癌(Epstein-Barr virus-associated gastric cancer,EBVaGC)中的表达及与临床病理特征、预后的关系;并分析Claudin18.2与PD-L1、ARID1A、HER2表达的相关性。方法收集胃癌根治手术标本694例,根据EBER检测筛选出25例EBVaGC进行逐一配对。应用免疫组化EnVision法检测Claudin18.2、PD-L1、ARID1A及HER2在EBVaGC及非EBV相关性胃癌(non-Epstein-Barr virus-associated gastric cancer,non-EBVaGC)中的表达;Kaplan-Meier法分析Claudin18.2、PD-L1、ARID1A表达与胃癌患者预后的关系;采用Spearman相关性分析Claudin18.2与PD-L1、ARID1A及HER2蛋白表达的相关性。结果免疫组化显示EBVaGC中Claudin18.2表达率/高表达率分别为76%和64%;而non-EBVaGC中Claudin18.2表达率/高表达率分别为32%和20%;Claudin18.2表达与胃癌肿瘤部位(近端胃)呈正相关。此外,与non-EBVaGC相比,EBVaGC中PD-L1 CPS评分高(P<0.001)、ARID1A表达缺失率高(P=0.012);而HER2表达差异无统计学意义。Kaplan-Meier生存分析表明,Claudin18.2表达/高表达不影响胃癌患者的总生存期。Sperman相关性分析显示:Claudin18.2与PD-L1表达呈正相关(r=0.3384,P=0.0162),Claudin18.2与ARID1A表达呈负相关(r=-0.3545,P=0.0115),Claudin18.2与HER2表达无明显相关性。结论Claudin18.2在EBVaGC中高表达,且Claudin18.2与PD-L1、ARID1A表达存在相关性,这为晚期胃癌患者的联合治疗方案提供了更多选择。Purpose To investigate the expression of Claudin18.2 and its relationship with clinicopathological parameters and prognosis in Epstein-Barr virus-associated gastric cancer(EBVaGC),and also to analyze the correlation between the expression of Claudin18.2 and PD-L1,ARID1A,and HER2.Methods Tissue samples of 694 patients received radical gastrectomy,and 25 cases of EBVaGC were selected according to EBER results and matched one by one.Immunohistochemistry was employed to assess the expression levels of Claudin18.2,PD-L1,ARID1A and HER2 in EBVaGC and non-EBVaGC.Kaplan-Meier survival analysis was performed for analyzing the relationship between the expression of Claudin18.2,PD-L1 and ARID1A and the prognosis of gastric cancer patients,and the survival curve was drawn.Spearman correlation analysis was used to assess the respective relationships between Claudin18.2 and PD-L1,ARID1A,and HER2.Results The positive/high expression rates of Claudin18.2 in EBVaGC were 76% and 64% respectively.Furthermore,the positive/high expression rates of Claudin18.2 in non-EBVaGC were 32% and 20%,respectively.Claudin18.2 expression showed positively correlations with the tumor site(proximal stomach)in gastric cancer patients.In addition,compared with non-EBVaGC,PD-L1 CPS score was higher in EBVaGC(P<0.001),and the deletion rate of ARID1A expression was also higher in EBVaGC(P=0.012).But there was no significant difference,and so did not the expression level of HER2 between EBVaGC and non-EBVaGC.Survival analysis revealed that positive/high expression of Claudin18.2 did not show a significant correlation with prognosis.Sperman correlation analysis indicated a positive correlation between Claudin18.2 and PD-L1(r=0.3384,P=0.0162),while the expression of Claudin18.2 was negatively correlated with ARID1A(r=-0.3545,P=0.0115).Finally,there was no significant correlation between Claudin18.2 and HER2.Conclusion Claudin18.2 is highly expressed in EBVaGC,which is correlated with PD-L1 and ARID1A.It provides more options of combination therapies for pa

关 键 词：胃肿瘤 EBV相关性胃肿瘤 Claudin18.2 生存 治疗 

分 类 号：R735.2[医药卫生—肿瘤]