위암의 조직형에 따른 HLA-DR 항원발현

Abstract

To prospect the significance of differences in HLA-DR antigen expression in two subtype of gastric carcinoma by Lauren's classification and its relationship with gastric inflammatory pattern, 60 cases of gastric carcinoma diagnosed from gastrectomy specimens were investigated. They were stained using the streptavidin biotin method with a mouse monoclonal antibody for class II HLA-DR antigen(Dako, Santa Fe, CA； HLA-DR/Alpha) at a concentration of 1 ： 30. The results were as follows: Staining for HLA-DR antigen was diffuse or patchy or focal and was both membranous and cytoplasmic. Of the 60 cases of gastric carcinoma were evaluated, 46 were of intestinal type, 14 of the diffuse type. The overall incidence of HLA-DR antigen expression was 29/60(48.33%). Intestinal type gastric carcinoma was 27/46(58.69%), compared with 2/14(14.28%) in diffuse type. The rate of HLA-DR antigen expression in two types is significantly different<P=0.02), All cases show various degrees of chronic gastritis with or without intestinal metaplasia and adjacent mucosa expressed HLA-DR antigen in 24/46(53.17%) in intestinal type and 5/14(35,71 %) in diffuse type. Positive staining of the adjacent mucosa were in gastric surface, foveolar and glandular epithelium. The expression of HLA-DR antigen in incomplete intestinal metaplasia with inflammation might be affected by a microenviroment with lymphoid infiltrate in which contained T cells. Thus these results suggest that HLA-DR antigen expression in gastric carcinoma is related with chronic gastritis with incomplete intestinal metaplasia especially to intestinal type. These suggest the notion that immunological mechanisms play a part in the initiation of gastric carcinoma, especially intestinal type, whereas diffuse type is thought to be related to genetic predisposition.