中下段直肠癌E-钙黏附素表达与淋巴结微转移的关系研究  

E-cadherin expression in middle and lower rectal carcinoma and its relationship with lymph node micrometastasis

作　　者：吴泽宇[1] 万进[1] 杜嘉林[1] 赵刚[1] 姚远[1] 刘全芳[1] 彭林[1] 王志度[1] 黄炽明[1] 杨珏[1] 

机构地区：[1]广东省人民医院普外三科,广东广州510080

出　　处：《外科理论与实践》2007年第4期373-375,共3页Journal of Surgery Concepts & Practice

基　　金：广东省医学科学基金资助(WSTJJ2000112736-580706003)

摘　　要：目的:分析中下段直肠癌E-钙黏附素(E-cadherin)表达与淋巴结微转移的关系。方法:应用CK-20免疫组化技术,对56例中下段直肠癌中661枚淋巴结微转移状况进行检测,同时观察肿瘤组织中E-钙黏附素的表达情况。结果:HE染色检测出29例中的190枚淋巴结呈转移,其CK-20免疫组化检测均呈阳性,后者在该29例中另检出12例55枚淋巴结呈阳性;在27例HE染色未检出淋巴结转移者中,有8例12枚淋巴结免疫组化检测呈阳性。20例(36%)67枚(10%)淋巴结检出微转移。中下段直肠癌E-钙黏附素表达阴性率为44.6%(25/56)。中下段直肠癌E-钙黏附素表达阴性与浸润深度(P=0.028)、分化程度(P=0.012)和淋巴结转移(P=0.007)密切相关。20例检测出淋巴结微转移的癌组织中14例(70%)E-钙黏附素表达阴性,而36例未检测出淋巴结微转移的癌组织中仅有11例(30.6%)E-钙黏附素表达阴性;二者差异有统计学意义(P=0.004)。结论:中下段直肠癌E-钙黏附素表达下调参与了淋巴结微转移的发生。Objective To detect the expression of E-cadherin in middle and lower rectal carcinoma, and its relationship with lymph node mlcrometastasis. Methods Cytokeratin-20 immunostaining was performed in 661 lymph nodes from 56 cases of middle and lower rectal carcinoma, which underwent total mesorectal excision and lymphadenectomy. The expression of E-cadherin in primary tumors was simultaneously detected by immunohistochemical staining. Results Micrometastasis was identified in 67 （10.1%） lymph nodes from 20 （35.7%） patients. The negative expression rate of E-cad- herin in primary tumors was 44.6% （25/56）. Significant relationship was found between E-cadherin expression and depth of tumor invasion （P=-0.028）, tumor differentiation （P=-0.012） and lymph node metastasis （P=-0.007）. E-cadherin expression was found to be negative in 14 of the 20 patients with lymph node micrometastasis, and 11 of the 36 patients without lymph node micrometastasis. The difference between these two groups was statistically significant （P=0.004）. Conclusions The results of the present study indicate that the down-regulation of E-cadherin expression may play an important role in the development of lymph node micrometastasis in patients with middle and lower rectal carcinoma.

关 键 词：直肠肿瘤 钙黏着糖蛋白类 淋巴转移 

分 类 号：R735.37[医药卫生—肿瘤]