老年人大肠腺瘤危险性分层及其与TGF-β信号通路蛋白表达的关系  

The Risk Stratification in the Aged Patients with Coloectal Adenoma and the Expression of TGFβ Signal Pathway Protein

作　　者：潘宏年[1] 汪发勇[1] 王修中[1] 魏文俊[1] 

机构地区：[1]六安市人民医院消化科,六安237005

出　　处：《临床消化病杂志》2010年第1期31-34,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：目的研究老年人结肠息肉的临床特点及其与癌变的关系。探讨高危型腺瘤与TGF-β信号通路蛋白表达的关系。方法对我院近几年经结肠镜检出的82例老年患者(≥60岁)结肠息肉的临床资料,观察其临床特点、内镜下表现及病理类型,并与96例中青年组(20～59岁)患者结肠息肉相比较。选取其中结直肠息肉标本110例,结直肠癌10例,以免疫组化染色检测TGF-β1、Smad3、Smad4在各组中的表达,并分析高危型腺瘤中TGF-β1、Smad3、Smad4表达与临床病理特征的关系。结果老年人结肠息肉的检出率高于中青年组,随年龄增加有升高趋势,病理类型以腺瘤为主。TGF-β1、Smad3、Smad4,在息肉组、结直肠癌组中的表达有显著差异(P<0.05),其表达与高危型腺瘤患者的临床病理特征均不相关。高危型腺瘤和DukesA期结直肠癌中TGF-β1、Smad3的表达有显著差异(P<0.05),而Smad4表达无显著差异。结论老年人大肠息肉中的腺瘤性息肉的大小、形态、数量及病理类型是其癌变的主要危险因素。TGF-β1通路可能参与了结直肠癌的发生过程,TGF-β1、Smad3可能在结直肠腺瘤的癌变早期起作用。Objective To study the clinical characteristics of colorectal polyps in the elderly and the canceration for colorectal polyps to explore the relationship of high risk colorectal adenoma and the expression of transforming growht factor（TGFβ） pathway.Methods We observed the clinical charactors enteroscopic and pathological models of 82 aged cases with colorectal polyps,and compared with 96 middle-younged cases in recent years.110 cases of colorectal polyps,10 colorectal cancer were enrolled.Expression of TGF-β1,Smad 3 and Smad 4 were detected by immunhistochemisty.The relationship between expression TGF-β1,Smad 3 and Smad 4 and clinicopathologic features in high risk adenoma was analyzed.Results The incidence of colorectal polyps in aged cases was higher than middle-younged cases and rised as age increased,most of pathological models were adenomas.Statiscal difference in expression of TGF-β1,Smad 3 and Samd 4 were found in polypsgroup and colorectal cancer（P0.05）.No significant relationship was found between clinicopathologic futures in high risk adenima and expression of TGF-β1,Smad 3 and Smad 4.Expression of TGF-β1 and Smad 3 in high risk adenoma was significantly higher than those in colorectal cancer of Dukes A stage（P0.05）,but not Smad 4.Conclusion Size,shope,amount and pathological models of adenomatous polyps are mainly dangerous factors in aged cases.TGF-β1 pathway may be involved in the tumor genesis of colorectal cancer and expression of TGF-β1 and Smad 3 may play some roles in the early stage of carcinogenesis of colorectal adenoma.

关 键 词：转化生长因子(TGF)β1 SMAD蛋白质类 老年人 大肠腺瘤 危险性分层 

分 类 号：R735.34[医药卫生—肿瘤]