胃と腸50巻12号

2015年11月発行

今月の主題 胃底腺型胃癌 主題研究

胃底腺型胃癌の発育進展様式と発癌機序

著者： 村上敬¹² 三富弘之³ 八尾隆史² 野村亮介¹ 李世容¹ 上山浩也¹ 日高康博¹ 松本健史¹ 齋藤剛² 長田太郎¹ 永原章仁⁴ 渡辺純夫¹

所属機関： ¹順天堂大学医学部消化器内科 ²順天堂大学大学院医学研究科人体病理病態学 ³関東労災病院病理診断科 ⁴順天堂大学医学部附属静岡病院消化器内科

ページ範囲：P.1559 - P.1565

要旨●胃底腺型胃癌のβ-catenin核内標識率は浸潤に伴い増加し，胃底腺ポリープ，通常型胃癌より高く，Wnt/β-cateninシグナル伝達系関連遺伝子の変異はAXIN2（27％），CTNNB1（15％），PPP2R1A（9％）と胃底腺ポリープや通常型胃癌より高率で，さらに同伝達系関連のSFRP1，APC，AXIN2遺伝子のメチル化率（67〜89％）も胃底腺ポリープより高い．また，胃底腺型胃癌（粘膜下層浸潤癌）ではGNAS遺伝子変異（19％），Kras遺伝子変異（8％）を認めるが，胃底腺ポリープや通常型胃癌ではほとんどみられない．以上から，胃底腺型胃癌の発育進展には胃底腺ポリープや通常型胃癌とは異なるWnt系およびGTP結合蛋白関連シグナル伝達系の活性化が関与すると考えられる．

参考文献

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