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위선암에서 Heregulin과 ErbB Family 단백 발현과 임상.병리학적 예후인자와의 상관관계
류창학,이주한,최종상,Yoo, Chang-Hak,Lee, Ju-Han,Choi, Jong-Sang 대한위암학회 2006 대한위암학회지 Vol.6 No.3
Purpose: Heregulin is a natural ligand for erbB3 and erbB4. However, very little is known about their roles in the gastric cancer This retrospective study was performed to evaluate the frequencies of heregulin and erbB family protein expression and to compare their expressions with clinicopathologic parameters. Materials and Methods: Immunohistochemical expressions of heregulin and erbB family proteins were examined with tissue micro-array slides. A total of 251 gastric adenocarcinomas were classified as early cancers and advanced cancers and as having and not having lymph node metastases. Results: The positive rates of the heregulin, erbB1, erbB2, erbB3, and erbB4 protein stainings were 64%, 68%, 6%, 88%, and 76%, respectively. Intestinal type gastric adenocarcinomas showed higher expression of heregulin, erbB2, erbB3, and erbB4 proteins. Heregulin and erbB4 proteins showed lower expressions in advanced gastric carcinomas. However, erbB2 protein showed higher expression in advanced gastric carcinomas. The protein expressions of heregulin and erbB family proteins showed no relationship with survival rate. Co-expression groups of heregulin and erbB3 proteins or heregulin and erbB4 proteins showed higher expressions in intestinal type adenocarcinomas and early gastric carcinomas. Conclusion: Heregulin, erbB3, and erbB4 proteins may play a role in the early stage of adenocarcinomas. 목적: Heregulin은 erbB3와 erbB4의 리간드로 작용한다. 그러나 위암에서 이들 단백의 역할에 대해서는 거의 알려져 있지 않다. 저자들은 위암에서 heregulin과 erbB family 단백 발현 빈도를 알아보고 이들 단백 발현과 임상 병리학적 예후인자와 비교하고자 한다. 대상 및 방법: Tissue microarray와 면역조직화학염색 방법을 이용하여 heregulin과 erbB 단백 발현을 검사하였다. 251 예의 위암을 조기위암, 진행성 위암, 림프절 전이 여부 등에 따라 구분하였다. 결과: Heregulin, erbB1, erbB2, erbB3, erbB4 단백은 각각 64%, 68%, 6%, 88%, 76%로 발현되었다. Heregulin, erbB2, erbB3, erbB4 단백은 장형에서 더 높은 발현을 보였다. Heregulin과 erbB4 단백은 진행성 위암에서 발현이 낮아졌다. ErbB2 단백은 진행성 위암에서 발현이 증가되었다. Heregvlin과 erbB family 단백은 생존율과는 상관관계가 없었다. Heregulin과 erbB3 혹은 heregulin과 erbB4 단백이 동시에 발현되는 군은 장형과 초기 병변에 더 많았다. 결론: Heregulin, erbB3, erbB4 단백들은 주로 위암 초기 병변에 관여하는 것으로 추정된다.
류창학(Chang Hak Yoo),노성훈(Sung Hun Noh),김용일(Yong Il Kim),서진학(Jin Hak Suh),민진식(Jin Sik Min),이경식(Kyong Sik Lee) 대한소화기학회 1998 대한소화기학회지 Vol.30 No.1
N/A Background/Aims: Prirnary gastric lymphoma is an uncommom tumor, constituting less than 5% of gastric malignancies. Optimal treatment of early-stage gastric lymphoma has been a matter of debate for several years. Our purpose in this study is to evaluate the exact role of surgery in the treatment of gastric lymphoma. Methods: Retrospective study of 63 patients, treated at the Dept. of Surgery, Yonsei Univ., College of Medicine from 1980 to 1994 was performed. Survival and multivariate analyses were done using the Kaplan-Meier method and Coxs proportional hazard model. Results: The mean age was 49.4 years, the ale to female ratio was 1.5:1 and the mean tumor size was 5.lcm in maximal diameter. The distribution of histologic grade according to the Working formulation was low-grade(n=24), intermediate-grade(n=32), high-grade(n=7) and high with low-grade(n=l). The distribution of stage according to the criteria of Musshoff was I(n=35), II-1(n=l 1), II-2(n=14), IV(n=3). Fifty two patients underwent gastric resection: subtotal(n=29), total (n=23) and the remaining 11 patients were diagnosed by laparotomy biopsy(n=4) and endoscopic biopsy(n=7) without gastric resection. Treatment modalities included surgery(S), chemotherapy (CT), and radiotherapy(RT) in the following proportions: only S(n=l9), S+CT(n=17), S+RT(n=4), S+CT+RT(n=12) and CT+RT(n=l 1). The overall 5-year survival rate was 72.5%. The 5-year survival rates according to stage were 87.3% in stage I, 76.2% in II-1, and 45.7% in II-2. No difference in survival rate was found according to treatrnent modality. Significant prognostic factors by univariate analysis were histologic grade, multifocality, lymph node metastasis, gastric resection and stage. Among them, independent prognostic factor by multivariate analysis was stage (p=0.0011). Conclusions: We suggested that surgical role in the treatment of early gastric lymphoma(stage I, II) may still be primary therapeutic procedure and the extent of sugical resection should be a standard radical gastrectomy with D2 or D2+a lymph node dissection. But in the intermediate or high grade tumor, multifocal lesions, LN metastasis and advanced stage, chemotherapy or radiotherapy should be considered as adjuvant therapy. (Korean J Gastroenterol 1997; 30:39 - 47)