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目的 探讨胃腺癌中紧密连接蛋白18.2(Claudin 18.2)的表达及其与临床病理特征间的关系。方法 收集北京大学第三医院2022年3月—2025年3月胃腺癌标本198例，采用免疫组化法检测 Claudin 18.2蛋白的表达，并根据染色强度和染色百分比进行半定量评分。分析Claudin 18.2 蛋白在胃腺癌中的表达及其与临床病理特征之间的关系。结果 198例胃腺癌中，手术标本133例（手术组），活检标本65例（活检组），其中手术标本中14例术前行新辅助治疗（术前行新辅助治疗组），Claudin 18.2在三组的阳性率分别为37.82%（45/119）、52.31%（34/65）、35.71%（5/14），三组间比较差异无统计学意义（P=0.143）。在低分化及Lauren分型为弥漫型的胃腺癌中Claudin 18.2的阳性率分别为48%及58.93%，明显高于高-中分化及Lauren分型为肠型/混合型（P<0.05）。在进行了PD-L1检测的病例中，CPS<1分组较CPS≥1分组的Claudin 18.2 表达水平更高，差异有统计学意义（P<0.05）。而Claudin 18.2蛋白的表达与患者年龄、性别、淋巴结转移、TNM分期、HER2及EBER表达、MMR状态均无显著相关性。结论 Claudin 18.2蛋白作为胃腺癌治疗领域的新型生物学标志物，其表达与胃腺癌的分化程度、Lauren分型有相关性，其在低分化腺癌和PD-L1 CPS<1的病例中表达率较高可为这2类胃癌患者提供新的治疗选择。
Abstract：Objective To investigate the expression of claudin 18.2， a tight junction protein， in gastric adenocarcinoma and its relationship with clinicopathological parameters. Methods A total of 198 gastric adenocarcinoma specimens were collected from Peking University Third Hospital from March 2022 to March 2025. The expression of claudin 18.2 protein was detected by immunohistochemistry， and semi-quantitative scoring was performed according to staining intensity and positive cell percentage. The expression of claudin 18.2 protein in gastric adenocarcinoma and its association with clinicopathological features were analyzed. Results Among the 198 cases， 133 were surgically-removed specimens and 65 were biopsy specimens. Of the surgical specimens， 14 received neoadjuvant therapy preoperatively. The positive rates of claudin 18.2 were 37.82% (45/119)， 52.31% (34/65)， and 35.71% (5/14)， respectively， with no significant difference among the three groups (P=0.143). The positive rates of claudin 18.2 in poorly differentiated and Lauren diffuse-type gastric adenocarcinoma were 48% and 58.93%， respectively， which were significantly higher than those in the well-to-moderately differentiated group and the Lauren intestinal/mixed-type group. Among cases tested for PD-L1， the expression level of claudin 18.2 was higher in the CPS<1 group than in the CPS≥1 group， with statistically significant differences between groups (P<0.05). However， no significant correlation was observed between claudin 18.2 protein expression and patient age， sex， lymph node metastasis， TNM stage， HER2 status， EBER expression， or MMR status. Conclusion As a novel biomarker in the treatment of gastric adenocarcinoma， Claudin 18.2 protein expression is correlated with the differentiation grade and Lauren classification of gastric adenocarcinoma. Its high expression rate in poorly differentiated adenocarcinoma and cases with PD-L1 CPS<1 provides a new therapeutic option for these gastric cancer patients.
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基本信息:
中图分类号:R735.2
引用信息:
[1]杜红禹,程荣勇,石雪迎.Claudin18.2蛋白在胃腺癌中的表达及其与临床病理特征的关系[J].诊断病理学杂志().
基金信息:
国家重大疾病多学科合作诊疗能力建设项目（胃肠道肿瘤综合诊治）
2026-08-27
2026-08-27
2026-08-27