Adhesion Molecule E-selectin Expression In Gastric Cancer Omentum Metastasis

Background:Gastric cancer is the most common gastrointestinal cancer in generalsurgery clinical. The trend of incidence of this disease has increased year by year,it hasclose relationship with today’s society living environment and diet structure. Only40%-50%advanced gastric cancer patients accepted radical resection, even after radicalresection, there are50%-90%of patients relapse and death,5-year survival ratehovering around30%..How to diagnose effectively,and how to treat peritoneummetastasis in general surgery clinical is a hotspot in recently research. Order ofperitoneal metastasis of greater omentum, pots peritoneum, diaphragmatic peritoneum,mesentery and abdominal wall, it is because peritoneal milky spots are selective sitesperitoneal metastasis, and the density distribution of milky spots consistent with theabove sequence gastric cancer metastasis, milky spots in the greater omentum andmainly distributed in the neighborhood near the1,2-level vessel branches, so the greateromental metastases is the good material of study the gastric cancer peritonealmetastasis.Gastric tumer’s biological activity and pathological stage and lot’s ofadhesion molecules expression paly important role in the process of gastric cancermetastasis. E-selectin is one of the members of the choose family meal in adhesionmolecule,it is selectin of endothelial cells,mainly expressed in the surface of activatedvascular endothelial cell. The study demonstrated that E-selectin is high expressed inthe patients suffering from gastrointestinal tumors and it is accompany with itspathological process,such as growth、invation and metastasis，making it become a newpredictor in pathological stage of gastrointestinal tumors. Objective We tested expression of E-selectin molecules in tissue which gastric cancercell metastasize to the greater omental, and compared to the tissue which gastric cancercell don’t metastasize to the greater omental. To researched the relationship betweengastric cancer implantation metastasis and it expression. The function and meaning ofE-selectin plays important roles in the tumor metastasise and invasion. To probe theE-selectin molecular mechanism of gastric cancer cell which metastasize to the greateromental.Methods We selected patient documents which suffered from the total gastrectomy inthe first affiliated hospital of AnHui medical university from Jul2010to Nov2012, andselected60paraffin blocks from which patients suffer from gastric cancer the greateromental metastasis. The control group are60patient documents which don’t havegastric cancer the greater omental metastasis. All of this documents which were enrolledin study don’t receive chemotherapy and radiotherapy. All of this documents are fixedby formalin routinely, and analysed qualitative by the technical of immunolhistochemistry this two groups document to research the expression of E-selectin andanalyse those two group’s gtvnx the expression of E-selectin and the relationship withclinical factors.ResultsLocalizaion of expression:E-selectin express in the blood vessel endothelium of tumortissue which express in the kytoplasm. E-selectin also express in the tumorcytomembrane.E-selectin in the gtvnx of gastric cancer:About55documents,express in the bloodvessel endothelium of tumor tissue gtvnx is positive at the60groups, positive rate is91.7%,but at the control group is34documents, positive rate is56.7%,also havesignificant difference(P=0.002).E-selectin express in the omentum majus which is gastric cancer metastasise cell:58documents which are E-selectin express in omentum majus is postive at60 document’s group, and the positive rate is96.7%, but at the control group, there are12documents is positive which E-selectin express at tissue of omentum majus, the positiverate is20%. This two groups have significant difference（p=0.000）.We analysed those60documents which are gastric cancer omentum metastasis andgastric cancer don’t has omentum metastasis and gtvnx which is the relationship ofclinical pathology parameter. E-selectin express in the gastric cancer omentummetastasis is higher than gastric cancer don’t has omentum metastasis. E-selectinexpress at the tumor cell vessel, also in the tumor cytomembrane and also correlationwith tumor invasion (p=0.025), lymph node metastasis (p=0.010), ascites (p=0.029),presence or absence of vascular invasion, and perineural invasion (p=0.016) correlatedwith patient age (p=0.741), gender (p=0.186), tumor location (p=0.873) anddifferentiation (p=0.515), no greater omentum metastasis group and its expression isrelated to the depth of invasion only (p=0.002).ConclusionE-selectin express in the endothelium cell endochylema which are express in the bloodvessel endothelium of tumor tissue, also express in tumor cytomembrane. Along withdevelopment of illness, the E-selectin has a trend which is rising,that is, from the earlierstage of gastric cancer, the progressive stage of gastric cancer,lymphatic metastasis,the depth of infiltrate, accompanied with ascites,the vascular and omentum invasion，results to the omentum metastasis. E-selectin express in the greater omentum metastasisstrongly. Maybe E-selectin is an important tumor marker which cooperate with thedevelopment of gastric cancer, the lymphatic metastasis of gastric cancer, and greateromentum implantation metastasis.