| Background: Gastric cancer is one of the most common malignant tumors in humans, about 25% of gastric cancer patients are preoperatively or intraoperative diagnosed of peritoneal metastasis. Advanced gastric cancer patients have 50% of the patients'peritoneal metastasis of gastric cancer mortality. The mechanism of peritoneal metastasis of gastric cancer is comparing the current approved of"the seed - soil theory", in which the biological activity of cancer cells shed in the abdominal cavity, and formed the so-called "seed". While peritoneal tissue trauma due to surgery and other mechanical is easy to tumor cell proliferation, and formats the so-called "soil", the interaction between cytokines and other cytokines molecules co-promotes the occurrence of peritoneal metastasis. Recent studies show that chemokines and their receptors may play an important role in the tumor metastasis. Chemokines is a kind of small cytokines molecules cans Chemokines directional movement, According to the N-terminal sequence of cysteine residues into four categories: CXC, CC, and C, CX3C chemokines, the corresponding subject body for the CXCR, CCR, XCR, and CX3CR. Numerous studies show that the chemokine receptor CXCR1, CXCR2, CCR7 plays an important role in a variety of tumor dissemination and metastasis.Objective: To detect the chemokine receptors CXCR1, CXCR2, CCR7 in primary lesion, paracarcinomatous tissue, peritoneal metastasis to analyze the situation in the role of peritoneal metastasis of gastric cancer.Methods: First Affiliated Hospital of Dalian Medical University, 2002 -2010 peritoneal metastasis of gastric cancer specimens in 37cases,required to have paracarcinomatous tissue (more than 5cm from the tumor lesions), primary tumor, peritoneal metastasis. Another 100 cases were randomly selected over the same period without peritoneal metastasis of gastric cancer specimens, all of the cases were not conducted in the chemotherapy before surgery, specimens were fixed in formalin, embedded in paraffin after immunohistochemical SP method for the determination of chemokine receptors CXCR1, CXCR2, CCR7 expression. Univariate analysis of CXCR1, CXCR2, CCR7 in gastric cancer peritoneal metastasis in the clinical and pathological parameters of the expression of peritoneal metastasis of gastric cancer patients, telephone follow-up, respectively, analysis of chemokine receptor CXCR1, CXCR2, CCR7 expression, the median positive and negative survival time, logistic regression multivariate analysis.Results: The chemokine receptors CXCR1, CXCR2, CCR7 expression mainly in cytoplasm and membrane in the tumor cells. In 37 patients with peritoneal metastasis cases, CXCR1 in adjacent tissue, primary tumor, expression of peritoneal metastasis rates were: 45.9%, 81.1%, 94.6%; CXCR2 in adjacent tissue, primary tumor, peritoneal metastasis tissues espression rates were: 40.5%, 75.6%, 91.9%; CCR7 expression among the three rate: 5%, 78.3%, 89.2%. CXCR2, CCR7 in the peritoneal metastases and primary tumors, the expression of significant differences (p<0.05); CXCR1 in peritoneal metastases and primary tumors, the expression was not significantly different (p> 0.05). CXCR1, CXCR2, CCR7 in primary tumors and adjacent tissues are significantly different (p <0.05).In 100 gastric cancer patients without peritoneal metastasis in primary tumor specimens of CXCR1, CXCR2, CCR7 expression rates were: 57%, 51%, 60%. Without peritoneal metastasis and peritoneal metastasis of primary tumor specimens between the CXCR2, CCR7 expression was significantly different (p<0.05), while the expression of CXCR1 was no significant difference (p> 0.05).Univariate analysis of CXCR1, CXCR2, CCR7 peritoneal metastasis in gastric cancer between the different clinical expression of pathological parameters: CXCR2 in gastric cancer peritoneal metastasis were correlated with tumor invasion depth, differentiation, tumor size-related (p <0.05), with the patient's age, sex, tumor location, lymph node metastasis had no correlation (p>0.05); CCR7 in gastric cancer peritoneal metastasis were correlated with tumor invasion depth, differentiation degree, lymph node metastasis (p<0.05), and the patient's age, sex, tumor location, tumor size had no correlation (p> 0.05); and peritoneal metastasis in gastric cancer CXCR1 expression and tumor invasion depth, differentiation, tumor size, tumor site, lymph node metastasis, age, no correlation between gender (p> 0.05). Analysis of information obtained on the survival of peritoneal metastasis in patients with positive expression of CXCR1 median survival time was 10 months, CXCR1 expression of negative patients the median survival time was 11 months; CXCR2 expression was positive in the median survival time was 9.5 months, CXCR2 expression in negative median survival time was 15 months; CCR7 positive expression median survival time was 9 months, CCR7 expression of negative median survival time was 16 months. Multivariate regression analysis showed that the size of primary tumor, depth of invasion, differentiation, primary tumors, CXCR2, CCR7 positive expression is a risk factor for peritoneal metastasis of gastric cancer.Conclusion: 1.Peritoneal metastasis and no peritoneal metastasis of gastric cancer compared in the depth of invasion, differentiation, tumor size, lymph node metastasis were significantly different (p <0.05); and in gender, age, tumor site areas no difference (p> 0.05).2.Chemokine receptors CXCR1, CXCR2, CCR7 expression on tumor growth of gastric cancer; CXCR2, CCR7 expression and peritoneal metastasis of gastric cancer.3.CXCR2 peritoneal metastasis in gastric cancer, the positive expression and tumor invasion, differentiation, tumor size-related; and the patient's age, sex, tumor site no correlation; CCR7 in gastric cancer peritoneal metastasis were correlated with tumor depth of invasion, differentiation, lymphatic metastasis related; and the patient's age, sex, tumor location, tumor size had no correlation. And peritoneal metastasis in gastric cancer CXCR1 expression and tumor invasion depth, differentiation, tumor size, tumor site, lymph node metastasis, age, gender were not correlated.4.CXCR2 and CCR7 expression in the prognosis of patients with positive survival time was significantly lower than the expression of CXCR2 and CCR7-negative patients. Tumor size, depth of invasion, differentiation, chemokine receptor CXCR2 and CCR7 expression constitutes a risk factor for peritoneal metastasis of gastric cancer. |
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