脂联素、瘦素、抵抗素的表达对判断结直肠癌临床分期及预后的价值  

Value of adiponectin,leptin and resistin expression in judging the clinical stage and prognosis of colorectal cancer

作　　者：刘冰[1] 张慧英[1] 刘国华 王琳[1] 杨邯平 LIU Bing;ZHANG Hui-ying;LIU Guo-hua;WANG Lin;YANG Han-ping(Department of General Surgery,Handan First Hospital,Handan 056000,China)

机构地区：[1]邯郸市第一医院普外科,河北邯郸056000

出　　处：《中国现代普通外科进展》2021年第1期15-19,23,共6页Chinese Journal of Current Advances in General Surgery

基　　金：河北省医学研究重点研究课题计划(20160338)。

摘　　要：目的:探讨结直肠癌组织中脂联素、瘦素、抵抗素表达水平与结直肠癌临床分期的关系及对预后判断的价值。方法:选取2015年2月—2016年2月收治的结直肠癌患者56例作为研究对象,术中收集癌组织和癌旁组织,另选取同期收治的行纤维结肠镜活检或切除并经病理证实的结直肠腺瘤患者52例为结直肠腺瘤组。分别采用免疫组织化学染色法和实时荧光定量(qRT-PCR)法检测脂联素、瘦素、抵抗素蛋白和mRNA的表达水平,分析三者与患者临床病理特征和预后关系。结果:癌旁组织、结直肠腺瘤组织及结直肠癌组织中脂联素蛋白及mRNA表达水平依次显著降低(P<0.05),瘦素、抵抗素蛋白及mRNA表达水平依次显著升高(P<0.05)。脂联素低表达、瘦素高表达、抵抗素高表达组患者TNM分期Ⅲ~Ⅳ期、Dukes分期C+D期、淋巴结转移及死亡比例明显高于脂联素高表达、瘦素低表达、抵抗素低表达组(P<0.05)。TNM分期Ⅲ~Ⅳ期、Dukes分期C+D期、淋巴结转移、脂联素低水平、瘦素高水平、抵抗素高水平是结直肠癌患者不良预后的独立危险因素(P<0.05)。三者联合检测预测患者不良预后的曲线下面积为0.926(95%CI:0.855~0.996),敏感度为90.60%,特异度为87.50%。结论:结直肠癌患者癌组织中脂联素表达水平明显降低,瘦素、抵抗素表达水平明显升高,可能与患者临床分期增加和不良预后发生风险增加有关,三者联合可能作为生物标志物,用于评估结直肠癌患者预后。Objective:To investigate the relationships between the expressions of adiponectin,leptin,resistin in colorectal cancer tissues and the clinical stage of colorectal cancer and its prognostic value.Methods:56 patients with colorectal cancer admitted from February 2015 to February 2016 were selected as the study objects,the cancer tissues and adjacent tissues were collected during the operation,and 52 patients with colorectal adenoma who underwent colonoscopy biopsy or resection and confirmed by pathology were selected as the colorectal adenoma group.The expression levels of adiponectin,leptin,resistin proteins and mRNAs were detected by immunohistochemistry and real-time fluorescence quantitative analysis(qRT-PCR),and the relationships between the three levels and the clinicopathological characteristics,prognosis of patients were analyzed.Results:The expression levels of adiponectin protein and mRNA in paracancerous tissue,colorectal adenoma tissue and colorectal cancer tissue were significantly decreased(P<0.05),and leptin,resistin protein and mRNA expression levels were significantly increased(P<0.05).The proportion of TNM stageⅢ-Ⅳ,Dukes stage C+D,lymph node metastasis and death rate in low adiponectin expression,leptin high expression and resistin high expression group were significantly higher than those in high adiponectin expression group,low leptin expression group and low resistin expression group(P<0.05).TNM stageⅢ-Ⅳ,Dukes stage C+D,lymph node metastasis,low level of adiponectin,high level of leptin and high level of resistin were independent risk factors for poor prognosis in patients with colorectal cancer(P<0.05).The area under the curve of predicting the adverse prognosis of patients by the combined detection of the three was 0.926(95%CI:0.855~0.996),the sensitivity was 90.60%,and the specificity was 87.50%.Conclusion:The expression level of adiponectin in colorectal cancer tissue is significantly decreased,the expression levels of leptin and resistin are significantly increased,which may be re

关 键 词：结直肠癌 脂联素 瘦素 抵抗素 临床分期 预后 

分 类 号：R735.35[医药卫生—肿瘤]