| Background and ObjectiveGastric cardiac carcinoma (GCA) is one of the most frequent malignant carcinomas in northern area of China. The significant epidemiologic feature of GCA is accord with the geographical distribution of esophageal squamous cell carcinoma (SCC). In the recent 20 years, carcinomas of the distal stomach have been decreasing in incidence, whereas proximal (cardia and gastroesophageal junction) carcinomas have been increasing dramatically in the West. Its incidence rises nearly 6 times at 20 percent yearly. The proximal carcinomas increase most quickly in all malignant carcinomas, whose mechanism has so far not been clear. GCA has visible discordance with carcinomas of the distal stomach in epidemiology, pathopoiesis factor, pathematology and clinical feature, and so on. Short of sensitive characteristic indexes and means to early diagnosis, high performance and specific prevention and cure methods is the main cause which induces the high death rate and bad prognosis of GCA. At present, the main therapy is operation. But prognosis has so far not been satisfied. The main cause of postoperative death is recrudescence and metastasis of carcinomas. So we should not only make use of clinical data for treatment, but find predicable factors, make accurate judgement for prognosis, look for patients to trend to be malignant, and carry out post-operation treatment in time, which is very important. Recent researches find that E-cadherin,β-catenin and Adenomatous Polyposis Coli (APC) is close with cell multiplication, which is reported that their expression is related with the clinical significance of many carcinomas.To study the expression of E-cadherin,β-catenin,APC and their relationship with the tumor clinical pathological factors in gastric cardiac cancer.Materials and Methods1. All samples were collected from the Second Affiliated Hospital of Zhengzhou University and Henan Tumor Hospital, including 63 surgically resected gastric cardiac carcinoma samples and 20 normal gastric cardiac mucosa samples. All the tissues were fixed in 10% neutral formalin and embedded in paraffin.2. Immunohistochemical technique was used to detect the expression of E-cadherin,β-catenin,APC among 63 gastric cardiac cancer samples and 20 cases of adjacent mucosa tissue. The data were analyzed by software SPSS11.0, chi-square test was used to compare difference between groups; t-test or analysis of variance was used according to the groups.α=0.05 was considered as statistically significant value.Results1. The positive staining of E-cadherin andβ-catenin was mainly located in membrane and partly in cytoplasm, but the positive staining of APC was mainly located in cytoplasm.2. The positive rate of E-cadherin andβ-catenin and APC in gastric cardiac carcinoma was significantly lower than which in normal mucosa (P<0.01).3. (1) The positive rate of the three in patients' ages and sex was not significant (P>0.05). (2) The positive rate of E-cadherin and APC was not significant in Tubular adenocarcinoma, signet-ring cell carcinoma and mucinous adenocarcinoma (P>0.05), butβ-catenin was (P<0.05). (3) The positive rate of the three was significant in differentiation grade (P<0.05). (4) The positive rate of the three in the group with serosa infiltration was significantly lower than which in the group without serosa infiltration (P<0.05). (5) The positive rate of the three in the group with lymph node metastasis was significantly lower than which in the group without. lymph node metastasis (P<0.05). (6) The positive rate of the three in III+IV stages was significantly lower than which in I + II stages (P<0.05).4. Spearman correlation showed that E-cadherin had a positive correlation withβ-catenin in gastric cardiac carcinoma, r_s=0.393(P<0.01).5. Spearman correlation showed that E-cadherin had a positive correlation with APC in gastric cardiac carcinoma, r_s=0.452(P<0.05).6. Spearman correlation showed thatβ-catenin in had a positive correlation with APC in gastric cardiac carcinoma. r_s=0.360 (P <0.01).Conclusions1. The positive expression of E-cadherin,β-catenin and APC in normal mucosa was significantly higher than that in gastric cardiac carcinoma. The abnormal expression of E-cadherin,β-catenin and APC was correlated with differentiation grade, infiltration depth, lymph node metastasis, and TNM stages, andβ-catenin also was correlated with histological grade, but not with ages and sex. The abnormal expression of E-cadherin,β-catenin and APC might participate in the process of gastric cardiac carcinogenesis and the progression of gastric cardiac carcinoma.2. The expression of E-cadherin,β-catenin and APC in gastric cardiac carcinoma shows significant relation. The abnormal expression of E-cadherin,β-catenin and APC may play an important role in the progression of gastric cardiac carcinoma.3. We detected the expression of E-cadherin,β-catenin and APC. It may be valuable biological parameters for early diagnosis and prognostic gastric cardiac carcinoma, instruct the clinical biotherapy and prevent recrudescence and metastasis of gastric cardiac carcinoma.
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