美国外科病理学杂志 | 具有原始肠上皮细胞表型的胃癌-一种肠型腺癌的侵袭性亚型

二郎神

　　摘要：原始细胞样基因表达标记物与多种癌症的侵袭性表型相关。我们评估了胃癌原始细胞特征性表型标记物的表达及其与临床病理、分子特征的关系。应用组织芯片对386例胃癌标本进行一组原始细胞表型标记物的免疫组织化学分析，包括胚胎干细胞标志物(OCT4、NANOG、SALL4、CLDN6和LIN28)和已知的癌胚蛋白(AFP和GPC3)。基于表达谱，将386例肿瘤分为3组：组1(原始表型，n=93)：AFP、CLDN6、GPC3阳性或SALL4弥漫阳性；组2(SALL4局灶阳性，n=56)：SALL4仅局灶性阳性；组3(阴性，n=237)：所有标记均为阴性。组1和组2主要由肠型腺癌组成，其中包括13例胎儿肠样腺癌(全部见于组1)。与组2和组3相比，组1与高T分期、脉管侵犯和淋巴结转移显著相关，提示患者预后不良，是无病生存的独立危险因素。组1还常表现为TP53过表达，但是与EB病毒或错配修复缺陷几乎不相关。癌症基因组图谱(the cancer genome atla,TCGA)数据集的进一步分析证实了我们的观察结果，显示具有原始表型的肿瘤在癌症基因组图谱的分子分类中大部分被归类为“染色体不稳定性”。我们发现具有原始肠上皮细胞表型的胃癌为肠型/染色体不稳定性胃癌的一种侵袭性亚型。针对原始标记物，如GPC3、CLDN6和SALL4的治疗策略前景广阔。

　　美国外科病理学杂志

　　来源：Am J Surg Pathol 2017;41:989–997

　　美国外科病理学杂志中文版2017年第一期摘要No.8

　　（李惠 翻译；章宜芬 审校）

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