| Objective:To investigate the the expressions of human telomerase reverse transcriptase (hTERT)and Spleen tyrosine kinase(Syk)in the gastric cancer and its surgical margin tissues,to explore the molecular margin in the gastric cancer.To study the infiltrated distance of cancer cells in the peripheral tissues,from histopathology and molecular pathology aspects,to provide the evidence for evaluating the security of surgical margin in the radical gastrectomy.Methods:39 gastric cancer patients who underwent radical operation were included in the study.Tumor,peripheral tissues within 5cm away from the tumor margin were collected from each fresh resected specimen,and the gastric tissues within 5cm from the upper and lower margins of the tumor was sliced transversely every 1cm.HE stained serial sections were made for the histopathologic examination.The expressions of hTERT and Syk were detected by immunohistochemistry in the gastric cancer and its approximail peripheral tissues 1cm,2cm,3cm,4cm and 5cm.away from the cancer margin.Results:1.Found microscopically,the tumor infiltration in the upper and lower margin 1cm away from tumor margin were 5 of 39 patients(12.8%)and 3 of 39 patients(7.69%),respectively.The tumor infiltration in upper and lower margin 2cm away from tumor margin were 3 of 38 patients(8.33%)and 2 of 36 patients(5.56 %),respectively.There was no tumor infiltrated in tissues 3cm away from tumor margin.The tumor infiltration rates of the upper and lower margin decrease as the distance increase from the tumor.2.The positive rates of hTERT in gastric cancer was 69.23%,whereas we detected no hTERT in any normal tissue.The incidence of hTERT in gastric cancer tissues was not correlated to age,sex,tumour sizes,infiltrate deep,lymph node metastasis,histological classification,TNM stage.In the upper margin,the positive rates of hTERT in the tissues 1cm,2cm,3cm,4cm,5cm away from tumor margin were23.08%,10.53%,2.70%,0%,0%,respectively.In the lower margin,the positive rates of hTERT in the peritumor tissues 1cm,2cm,3cm,4cm,5cm away from tumor margin were 20.51%,8.33%,0%,0%,0%,respectively.3.The positive rates of syk in gastric cancer was 5.13%,whereas we could detecte syk in every normal tissue.In the upper margin,the positive rates of Syk in the tissues 1cm,2cm,3cm,4cm,5cm away from tumor margin were 58.97%,63.16 %,78.38%,96.97%,100%,respectively.in the lower margin,the positive rates of Syk in the peritumor tissues 1cm,2cm,3cm,4cm,5cm away from tumor margin were 41.03%,66.67%,89.29%,23.53%,0%,respectively.4.The positive rates of hTERT expression from the cancer center to the surrounding surgical margin tissues were gradually diminishing(p＜0.001),hTERT can't be dectected in 4cm away in the upper end or 3cm away in the lower end of margin tissues.Contrarily,the positive rates of Syk expression from the cancer center to the peripheral tissues were gradually increased(p＜0.001).In the upper surgical margins,the rate of Syk in the 4cm away was significantly higher than the 3cm away peripheral tissues(p＜0.05).In the lower tumor surgical margins,the rate of Syk in the 3cm away was significantly higher than the 2cm away peripheral tissues(p＜0.05).Conclusions1.The pathologic infiltration along the upper and lower margin was within 3cm.3cm proximal and distal to the tumor may be the histopathologic margin in the radical operation for gastric cancer.2.The expression of hTERT in the gastric cancer were high,The expression of SYK in the gastric cancer were low or even deletion.The differential expression of hTERT and SYK in gastric cancer tissue and its surrounding tissue indicate the presence of molecular margin around gastric cancer tissue,hTERT and Syk were good molecular markers for the study of surgical margin in the radical operation 3.Molecular pathology is superior to histopathology in detecting infiltration.Sensitivity in the detecting would be elevated when two methods combined.4.Considering hTERT and SYK expressions,4 cm away in the upper and 3 cm away in the lower margin tissues can be defined as molecular margin.
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