Twist蛋白在结直肠癌和肝转移组织中的表达及临床意义  

Expression of Twist protein in colorectal cancer liver metastasis and its clinical significance

作　　者：袁强[1,2] 李世拥[2] 陈纲[2] 蔡慧云[2] 安萍[2] 

机构地区：[1]山西医科大学第二临床医学院,太原030001 [2]北京军区总医院全军普通外科中心

出　　处：《中华普外科手术学杂志（电子版）》2014年第2期44-47,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金资助项目(30471700);(30772118)

摘　　要：目的探讨Twist蛋白在结直肠癌及肝转移组织中的表达及其临床意义。方法选取2001年1月至2012年12月伴有肝转移的结直肠癌患者成套组织标本(原发灶、肝转移灶、距肿瘤边缘10 cm以上的正常结直肠黏膜组织)54例患者。采用免疫组织化学SP法检测54例患者标本的原发灶、肝转移灶及正常结直肠黏膜组织中Twist蛋白的表达,数据分析处理采用SPSS 19.0统计软件包,计数资料采用R×C表资料的χ2检验,生存分析采用Kaplan-Meier生存曲线法,Log-rank检验分析肿瘤浸润程度、淋巴结转移、组织学分型及Twist蛋白在原发灶及肝转移灶中表达的情况,采用Cox回归模型进行独立预后因素分析。结果 Twist蛋白在结直肠癌原发灶中的阳性表达率明显高于肝转移灶、正常结直肠黏膜组织(P<0.001);原发灶中Twist蛋白在不同浸润深度T2、T3、T4的阳性表达率分别为30.0%、64.9%、85.7%,其差异有统计学意义(P=0.049);单因素分析显示,原发灶及肝转移灶中Twist蛋白阳性表达组患者的总体生存率均显著低于阴性表达组(P=0.034,P=0.031);多因素生存分析证实肿瘤浸润深度、淋巴结转移和肿瘤组织学分型为影响患者总体生存率的独立因素(P<0.001,P=0.002,P=0.005),而Twist蛋白在原发灶及肝转移灶中的表达不是总体生存率的独立因素(P=0.548,P=0.742)。结论 Twist蛋白在结直肠癌肝转移患者的原发灶高表达,其可能参与结直肠癌肝转移的发生,对评价结直肠癌肝转移患者预后具有一定临床意义。Objective To investigate the expression of Twist protein in colorectal cancer liver metastasis and its clinical significance . Methods From January 2001 to December 2012, tissue specimens of 54 patients with colorectal cancer liver metastasis were collected , including primary neoplasm , liver metastasis and corresponding normal colorectal mucosa more than 10 cm distant from primary neoplasm . Expression of Twist protein in collected tissues was detected by immunohistochemistry staining using the SP method.Statistical analysis was performed using SPSS 19.0 software the chi-square test, Kaplan-Meier curve, Log-rank test and Cox-regression model . Results The expression of Twist protein was up-regulated more significantly in primary neoplasm than that in liver metastasis or in normal colorectal mucosa （P〈0.001）.In primary neoplasm, positive Twist expression in primary neoplasm was detected in 30.0%, 64.9%and 85.7%of patients with T2, T3 and T4 staging, respectively（P=0.049）.Single factor analysis showed that the overall survival of patients with Twist-positive primary neoplasm or liver metastasis cases was significantly shorter than that in Twist-negative cases （P=0.034, P=0.031, respectively）.Multiple factor analysis showed that T staging, N staging and the differentiation of primary neoplasm were the independent predictive factors for the overall survival of patients with colorectal cancer liver metastasis （P〈0.001, P=0.002, P=0.005）, except for the expression of Twsit in primary neoplasm or liver metastasis of patients （ P =0.548, P =0.742, respectively ） . Conclusions The expression of Twist protein was increased in primary neoplasm of patients＆amp;nbsp;with colorectal cancer liver metastasis , which might be associated with the mechanism of liver metastasis . Twist protein expression might help to predict the prognosis of patients with colorectal cancer liver metastasis .

关 键 词：TWIST转录因子 结直肠肿瘤 肿瘤转移 

分 类 号：R735.34[医药卫生—肿瘤]