结直肠癌转移相关基因表达及其临床病理意义  

Expression of metastasis-related g enes in colorectal cancer and it's clinicopathological significance

作　　者：李继坤[1] 陈进[1] 李远芳[2] 陈忠伟[2] 

机构地区：[1]上海市第一人民医院外科,200080 [2]复旦大学医学院肿瘤医院病理科

出　　处：《中华胃肠外科杂志》2002年第3期213-216,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的评价P53、血管内皮生长因子(VEGF)、上皮钙黏附蛋白(E-CD)、α-连环蛋白(α-CA)及β-连环蛋白(β-CA)在结直肠癌转移潜能和预后判断中的价值。方法应用免疫组织化学ABC法检测76例结直肠癌组织中P53、VEGF、E-CD、α-CA及β-CA的表达。结果(1)结直肠癌组织中P53表达阳性率为47.4%,伴有肝转移的结直肠癌P53阳性表达率明显高于无肝转移者(P<0.05);VEGF表达阳性率为57.9%,VEGF表达阳性的结直肠癌易发生淋巴结转移和肝转移(P<0.01);E-CD、α-CA和β-CA表达在结直肠癌组织中均明显减弱,且与结直肠癌的分化程度密切相关(P<0.01);E-CD表达与结直肠癌转移无明显的相关关系(P>0.05);α-CA、β-CA表达减弱与结直肠癌淋巴结转移显著相关(P<0.01),但与肝转移发生无相关(P>0.05)。(2)P53与VEGF表达显著相关(P<0.05)。(3)Cox模型多因素分析表明,P53和VEGF表达阴性的结直肠癌患者预后较好,而α-CA和β-CA表达减弱者预后较差(P<0.01)。结论结合分析P53、VEGF、α-CA及β-CA的表达有助于对结直肠癌转移方式、转移潜能及预后的判断。Objective To evaluate the values of P53,vascul ar endothelial growth factor(VEGF),E-cadherin(E-CD),α-catenin(α-CA)andβ-catenin(β-CA)for assessment of metastatic potent ial and prognosis in colorectal cancer.Methods Avidin-biotin complex method was used to examine the expression of P53,VEGF,E-CD,α-CA andβ-CA in 76cases of colorectal cancer.Results The positive rate of P53was 47.4%,and P53-positive expression was found more frequen tly in patients with liver metastases than that without liver metastases(P<0.05).The positive rate of VEGF was 57.9%,the frequency of lymph node or liver meta stases in VEGF-positive patients wa s significantly higher than that in VEGF-negative patients(P<0.01).Reduced expression of E-CD,α-CA andβ-CA was observed frequently in colorectal cancers,which was sig nificantly correlated with tumor di fferentiation(P<0.01).No correlation was found between E-CD e xpression and incidence of metastases.Reduced expression ofα-CA andβ-CA was correlated with lymph node me tastases(P<0.01),but not with the occurrence of liver metastases in colorectal cancers(P>0.05).There was significant correlated b etween P53and VEGF expression(P<0.05).The multivariate Cox regression mo del indicated that the patients with negative P53or VEGF expression had a good prognosis,while those with reducedα-CA orβ-CA expression had a poor prognosis(P<0.01).Conclusion Combined analysis of P53,VEGF,α-CA andβ-CA expression may be useful for predicting metastatic mo de,metastatic potential and prognosis of patients with colorectal cancer.

关 键 词：结直肠癌 临床病理 基因表达 肿瘤转移 预后 结肠癌 直肠癌 

分 类 号：R735.37[医药卫生—肿瘤]