摘要
建立一种新的胃癌细胞功能分类方法；探索胃癌细胞功能分化特征与其病理生物学行为，特别与局部侵袭和远隔转移的关系。方法：按胃癌细胞的功能分化方向，将361例胃癌分为5种类型。结果：①吸收功能分化型(AFDT):82例，占本组资料的22.7%；此型中中老年男性占92.7%，84.1%为肠型胃癌，46.3%表达CD44v6；属此型的男性中13.6%(9/66)伴肝脏转移；术后5年生存率(58.5%)明显高于除特殊功能分化型(SFDT)胃癌以外的其他型，(P<0.01)。②粘液分泌功能分化型(MSFDT):54例，占全组的15%,以局部垂直向胃壁深层侵袭为主，手术时绝大多数(98.1%，53/54)已侵透浆膜，术后5年生存率为28.6%。③吸收-粘液产生功能双向分化型(AMPFDT):180例，占全组的49.9%，<45岁的青年患者(17.2%)和女性(34.4%)明显多于其他型；雌激素受体表达率(71.7%,129/180)明显高于其他型；女性中19.4%(12/62)伴有卵巢转移，术后5年生存率最低(24.7%)。④特殊功能分化型(SFDT):13例，占全组的3.6%；69.2%(9/13)属APUD来源，30.7%(4/13)为不同形态学分化的胃癌；术后5年生存率为60%。⑤无功能分化型(NFDT):32例，占全组的8.9%；其中19例(59.4%)伴转移，且均为淋巴结转移，而未见肝或卵巢转移；术后5年生存率为28.1%。
To study the correlation between the functional differentiation feature of gastric cancer cells and the invasion, metastasis and prognosis of gastric cancer(GC); trial at a new cell-functional classification of gastric cancer. Methods: Three hundred and sixty-one surgically resected specimens of GC were investigated in terms of enzyme, mucin-, and tumor-associated markers by immunohistochemistry. According to the trend of cell-functional differentiation, stomach cancers were divided into 5 types as following. Results: (1) Absorptive function differentiation type(AFDT): 22.7% of the whole series(82/361). Seventy-six out of 82 patients(92.7%) belonging to this group were over 45 years old, 69 cases(84.1%) belonged to the intestinal-type GC, 38 cases(46.3%) expressed CD44v6, and 9(13.6%) out of 66 male patients developed liver metastasis. The patients with this type enjoyed a 5 year-survival rate of 58.5%(48/82). (2) Mucin secreting function differentiation type(MSFDT): 15% of the series; 98.1%(53/54) of cases of this type had the serosa involved at operation; the 5-year survival rate was 28.6%. (3) Absorptive and mucin-producing function differentiation type(AMPFDT): 49.9% of the series. This type occurred frequently in patients younger than 45 years old(17.2%, 31/180), and especially in the female(34.4%, 62/180); the estrogen receptors(ER)(71.7%, 129/180) were expressed more often than the other types(P<0.01); ovary metastasis was found in 12 out of the 62 female subjects(19.4%); this type showed the lowest 5-year survival rate(24.7%) of all types. (4) Specific function differentiation type(SFDT): 3.6% of the series. Nine out of 13 tumors(69.2%) of this type derived from APUD, the other 30.7%(4/13) showed different histolo- gical differentiation; 60% of the patients of this type survived for at least five years. (5) Non-function differentiation type(NFDT): 8.9% of the series; 59.4%(19/32) of the tumors developed lymphatic metastasis but without any liver or ovary metastasis; the 5-year survival rate was 28.1%.Conclusions: (1) This new classification of GC based on cellular function is helpful in indicating the pathobiological behavior and characteristics of invasion and metastasis of gastric cancer; (2) Further study is needed to disclose the correlation between the cell-functional differentiation phenotypes and their relevant genotypes of gastric cancers.
出处
《外科理论与实践》
2000年第3期146-151,共6页
Journal of Surgery Concepts & Practice
基金
本课题受国家自然科学基金!(No.39270300
No.39370772)
教育部跨世纪优秀人才培养计划基金资助
关键词
功能分型
胃肿瘤
肿瘤转移
病理生物学
Cell-functional classification Metastasis Prognosis Stomach neoplasm
