食管胃交界腺癌和远端胃癌KLF4 SP1及Cyclin D1表达的对比研究

摘要

Objective:Recent studies have shown that in contrast to decrease in distal gastric adenocarcinoma (DGA), incidence of adenocarcinoma of the esophagogastric junction (AEG) has increased noticeably in numerous counties. However, the reasons remain unclear. This study evaluated the possible differences in the expression of KLF4, SP1, and Cyclin D1 in AEG and DGA, and explored the potential carcinogenesis of AEG. Methods:Immunohistochemistry was performed on paraffin-embedded tissues to evaluate the pu-tative differences in the expressions of KLF4, SP1, and Cyclin D1 at protein level between AEG (n=58) and DGA (n=47). The patholog-ical significance of these markers between the two groups was also compared and analyzed. Results:The percentage of positive KLF4 expression was significantly lower in DGA than in AEG (P<0.05). Lower KLF4 expression was found both in well-or moderately dif-ferentiated cases and in poorly differentiated cases with DGA compared with their AEG counterparts (P<0.05). However, positive stain-ing for SP1 was significantly higher in DGA (P<0.05). No significant difference was found in the expression of Cyclin D1 between the two groups. Further analysis showed that in DGA, the positive expression of KLF4, SP1, and Cyclin D1 were significantly correlated with lymph node metastasis. In AEG, only Cyclin D1 expression was correlated with lymph node metastasis (P<0.05). No correlation was found among the expression of KLF4, SP1, and Cyclin D1 in AEG. In DGA, KLF4 was inversely correlated with SP1 and Cyclin D1 (r=-0.334 and r=-0.341, respectively, P<0.05), and SP1 was positively correlated with Cyclin D1 expression (r=0.340, P<0.05).Conclusion:Different expression patterns and clinicopathological significance of KLF4, SP1, and Cyclin D1 were observed between AEG and DGA, suggesting the putative difference in the carcinogenesis and progression of AEG and DGA.%目的：近些年研究发现胃食管交界腺癌的发生率较远端胃癌明显升高，但其发生机制目前并不清楚，本研究通过对比观察KLF4、SP1和Cyclin D1在食管胃交界腺癌和远端胃癌表达的差异，探讨食管胃交界腺癌发生的可能机制。方法：采用免疫组织化学染色法对比观察58例食管胃交界腺癌和47例远端胃癌组织中KLF4、SP1和Cyclin D1在蛋白水平上的表达差异以及与淋巴结转移的关系。结果：KLF4在远端胃癌组中的阳性表达率明显低于食管胃交界腺癌组（P<0.05）；而且远端胃癌高中分化组和低分化组中KLF4的阳性表达率均明显低于相应食管胃交界腺癌组（P<0.05）。SP1在远端胃癌组中的阳性表达率明显高于食管胃交界腺癌组（P<0.05）；而且远端胃癌高中分化组中SP1的阳性表达率均明显高于相应食管胃交界腺癌组（P<0.05）。Cyclin D1在食管胃交界腺癌组和远端胃癌组中的阳性表达率未见明显差异。进一步观察KLF4、SP1和Cyclin D1与淋巴结转移的关系，结果发现Cyclin D1的高表达与食管胃交界腺癌淋巴结转移有关；而KLF4、SP1和Cyclin D1的表达异常均与远端胃癌淋巴结转移有关。相关性分析结果显示在食管胃交界腺癌中KLF4与SP1和Cyclin D1之间未见明显相关关系；而在远端胃癌中KLF4与SP1以及KLF4与Cyclin D1（r=-0.334，r=-0.341，P<0.05）之间呈负相关；SP1与Cyclin D1之间呈正相关（r=0.340，P<0.05）。结论：食管胃交界腺癌和远端胃癌组织KLF4、SP1和Cyclin D1的表达和临床病理意义均存在一定差异，提示两种肿瘤在发生发展方面可能有所不同。