위암에서 Collagen-4 및 Type-4 Collagenase의 발현과 예후인자로서 임상적 응용

Abstract

Background/Aims: In Korea, gastric cancer is the commonest cancer and the leading cause of cancer-related death. Though the most effective treatment for gastric cancer is radical resection, there are many patients with gastric cancer inoperable at the time of diagnosis. Collagen-IV, one of the major intrinsic components of the basement membrane, has cell adhesion function and it is known to be associated with tumor invasion or penetration. Type- IV collagenase, a metallo- proteinase purified from highly metastatic tumor cells, has been implicated in the process of invasion of epithelial and endothelial basement membranes in several steps of tumor invasion and metastasis. Methods: We retrospectively reviewed the clinical records of SO patients with histologically proven gastric cancer who had been treated in Yonsei University Medical Center and Yonsei Cancer Center between June l985 and June 1990. We perfonned immunohistochemical staining of surgically resected specimens of stomach cancers to investigate the expression rate and clinical relevance of collagen-lV and type-IV collagenase as prognostic niarkers. Results: Collagen- IV expression rate was 50% in 40 gastric cancers and type-IV collagenas" expression rate was 76% in 50 gastric cancers. Six cases(30%) recurred in 20 collagen-IV positivc cases and six cases(30/c) recurred in 20 collagen-IV negative cases(p=1.00000). Eleven cases(29%) recurred in 38 type-P' collagenase positive cases and four cases(33%) recurred in 12 type-IV collagenase negative cases(p=0.77255). In the collagen-IV positive and negative group, 5-ye.ar disease-free survival rate was 607c and 67%, respectively(p=0.6725), and 5-year overal] survival rate was 71% and 827o, respectively(p=0.3953). In the type-IV collagenase positive and negative group, 5-year disease-free survival rate was 63% and 60%, respectively(p=0.6407), and 5-year ovevall survival rate was 78% and 60%, respectively (p=0.3822). Conclusions: Collagen-IV and type-lV collagenase were found in gastric tissues. However, together with recurrence rate and survival rat:, expressions of collagen- IV and type-IV collagenase were not significantly correlated with T state, nodal status, TNM stage and histologic differentiation of gastric cancer. Further studies to define the biological role of collagen-IV and type-IV collagenase is required.