100例伴转移的结直肠癌多因素预后分析  

Multi-factor analysis on prognosis in100cases of colorectal cancer with metastases

作　　者：张诗武[1] 刘岩雪[1] 赵秀兰[2] 邱志强[1] 孙保存[1] 

机构地区：[1]天津医科大学肿瘤医院肿瘤研究所,天津300060 [2]天津医科大学病理教研室

出　　处：《天津医科大学学报》2004年第4期535-538,543,共5页Journal of Tianjin Medical University

摘　　要：目的 :对伴转移的结直肠癌患者进行临床指标和肿瘤浸润转移相关分子生物学标志的多因素分析,以确定结直肠癌转移相关危险因素。方法:对100例临床预后资料完整的结直肠癌的原发灶和转移灶进行p27、p21、MMP -2、TIMP -2、Cathepsin -D、Paxillin、Survivin、FAK、ER和E -Cadherin免疫组织化学染色 ,根据染色指数结果应用COX比例风险回归模型评估上述临床及分子指标对结直肠癌患者预后的影响 ,同时还对原发灶和转移灶上述分子生物学指标免疫组化染色指数大小进行比较。结果:转移性结直肠女性患者预后好于男性患者(OR=7.984 ,P<0.05) ;手术后辅以放 (化 )疗患者预后要好于单纯手术治疗 (OR=0 016 ,P<0.01) ;原发灶 (或转移灶 )MMP -2和 p27染色指数高的结直肠癌患者预后差 (MMP -2 :OR=1.847 ,P<0.05 ;p27 :(OR=2.582 ,P<0.01) ,原发灶 (或转移性 )TIMP -2、FAK、ER染色指数高的患者预后好 (TIMP -2 :OR=0.265 ,P<0.05 ;FAK :OR=0.570 ,P<0.01;ER :OR=0.248,P<0.05) ;转移灶MMP -2(P<0.05)的染色指数要高于原发灶的表达 ,而原发灶Cathepsin -D的表达要高于转移灶的表达 (P<0.01)。结论:使用COX比例风险回归模型对上述临床和分子生物学指标进行分析可以较客观地评价转移性结直肠癌患者预后。Objective:To analyse the clinical data and molecular biological markers of100cases of colorectal cancer with metastases was carried out.Methods:p27、p21、MMP-2、TIMP-2、Cathepsin-D、Paxillin、Survivin、FAK、ER and E_Cadherin immunohistochemical staining was made.According to the staining result(staining index),Cox's proportinal hazard regression was used to assess the influence of these clinic data and molecular biological markers to the patient's prognosis.Furthermore,the staining index of molecular biological markers was compared beˉtween primary focus and metastasis focus of colorectal cancer.Results:The prognosis was better in female patients than male patients(OR=7.984,P<0.05)and prognosis of operation with radiotherapy or chemotherapy group was better than simple operation group(OR=0.016,P<0.01).A high staining index of MMP-2、p27in primary tumors or metastases meant a bad prognosis(MMP-2:OR=1.847,P<0.05;p27:OR=2.585,P<0.01)and a low stainin index of Timp_2、FAK and ER in primary tumors or metastases meant a good prognosis(Timp-2:OR=0.265,P<0.05;FAK:OR=0.570,P<0.01;ER:OR=0.248,P<0.05).The staining index of MMP-2in metastases was higher than it in the primary lesion and the staining index of cathepsin_D in primary lesion was higher than it in metastases.Conclusion:Cox's proportional hazard regression is a objective evaluative method to access the prognosis of colorectal cancer with metastases.

关 键 词：结直肠癌 COX比例风险回归 转移 预后 

分 类 号：R735.37[医药卫生—肿瘤]