AIM:To reveal the correlation between the functional differentiation phenotypes of gastric carcinoma cells and the invasion and metastasis by a new way of cell-function classification.METHODS:Surgically resected speci...AIM:To reveal the correlation between the functional differentiation phenotypes of gastric carcinoma cells and the invasion and metastasis by a new way of cell-function classification.METHODS:Surgically resected specimens of 361 gastric carcinomas(GC)were investigated with enzyme-,mucin-,and tumor-related marker immunohistochemistry.According to the direction of cell-function differentiation,stomach carcinomas were divided into five functionally differentiated types.RESULTS:(1)Absorptive function differentiation type(AFDT):there were 82(22.7%)patients including 76(92.7%)aged 45 years.Sixty-nine(84.1%)cases belonged to the intestinal type.Thirty-eight(46.3%)expressed CD44v6 and 9(13.6%)of 66 male patients developed liver metastasis.The 5-year survival rate of patients in this group(58.5%)was higher than those with the other types(P【0.01).(2)Mucin secreting function differentiation type(MSFDT):54(15%)cases.Fifty-three(98.1%)tumors had penetrated the serosa,12(22.2%)expressed ER and 22(40.7%)expressed CD44v6.The postoperative 5-year survival rate was 28.6%.(3)Absorptive and mucin-producing function differentiation type(AMPFDT):there were 180(49.9%)cases,including 31(17.2%)aged younger than 45 years.The tumor was more common in women(62,34.4%,)and expressed more frequently estrogen receptors(ER)(129,81.7%)than other types(P【0.01).Ovary metastasis was found in 12(19.4%)out of 62 female subjects.The patients with this type GC had the lowest 5-year survival rate(24.7%)among all types.(4)Specific function differentiation type(SFDT):13(3.6%)cases.Nine(69.2%)tumors of this type derived from APUD system,the other 4(30.7%)were of different histological differentiation.Sixty per cent of the patients survived at least five years.(5)Non-function differentiation type(NFDT):32(8.9%)cases.Nineteen(59.4%)cases had lymph node metastases but no one with liver or ovary metastasis.The 5-year survival rate was 28.1%.CONCLUSION:This new cell-function classification of GC is helpful in indicating the characteristics of invasion and metastasis of GC with different cell-function differentiation phenotypes.Further study is needed to disclose the correlation between the cell-functional differentiation phenotypes and the relevant genotypes and the biological behavior of gastric carcinoma.展开更多
基金Project supported by the National Natural Science Foundation of China,No.39270300.No.39370772Training Program for Trans-Century Talents by the State Education Commission of China
摘要AIM:To reveal the correlation between the functional differentiation phenotypes of gastric carcinoma cells and the invasion and metastasis by a new way of cell-function classification.METHODS:Surgically resected specimens of 361 gastric carcinomas(GC)were investigated with enzyme-,mucin-,and tumor-related marker immunohistochemistry.According to the direction of cell-function differentiation,stomach carcinomas were divided into five functionally differentiated types.RESULTS:(1)Absorptive function differentiation type(AFDT):there were 82(22.7%)patients including 76(92.7%)aged 45 years.Sixty-nine(84.1%)cases belonged to the intestinal type.Thirty-eight(46.3%)expressed CD44v6 and 9(13.6%)of 66 male patients developed liver metastasis.The 5-year survival rate of patients in this group(58.5%)was higher than those with the other types(P【0.01).(2)Mucin secreting function differentiation type(MSFDT):54(15%)cases.Fifty-three(98.1%)tumors had penetrated the serosa,12(22.2%)expressed ER and 22(40.7%)expressed CD44v6.The postoperative 5-year survival rate was 28.6%.(3)Absorptive and mucin-producing function differentiation type(AMPFDT):there were 180(49.9%)cases,including 31(17.2%)aged younger than 45 years.The tumor was more common in women(62,34.4%,)and expressed more frequently estrogen receptors(ER)(129,81.7%)than other types(P【0.01).Ovary metastasis was found in 12(19.4%)out of 62 female subjects.The patients with this type GC had the lowest 5-year survival rate(24.7%)among all types.(4)Specific function differentiation type(SFDT):13(3.6%)cases.Nine(69.2%)tumors of this type derived from APUD system,the other 4(30.7%)were of different histological differentiation.Sixty per cent of the patients survived at least five years.(5)Non-function differentiation type(NFDT):32(8.9%)cases.Nineteen(59.4%)cases had lymph node metastases but no one with liver or ovary metastasis.The 5-year survival rate was 28.1%.CONCLUSION:This new cell-function classification of GC is helpful in indicating the characteristics of invasion and metastasis of GC with different cell-function differentiation phenotypes.Further study is needed to disclose the correlation between the cell-functional differentiation phenotypes and the relevant genotypes and the biological behavior of gastric carcinoma.