APC蛋白对结直肠癌前病变的检测意义  

Significance of APC protein in detecting colorectal precancerous lesions

作　　者：胡磊 唐长凌 张寅刚 HU Lei;TANG Changling;ZHANG Yingang(Department of General Surgery,Deqing Hospital,Run Run Shaw Hospital Affiliated to Zhejiang University,Huzhou,Zhejiang,313200,China)

机构地区：[1]浙大邵逸夫医院德清院区普外科,浙江湖州313200

出　　处：《当代医学》2021年第9期94-96,共3页Contemporary Medicine

摘　　要：目的明确APC蛋白在结直肠息肉-腺瘤伴癌前病变-早期癌变进展序列中的表达率变化,探讨APC蛋白表达率与患者的预后、结直肠肿瘤复发的关系,阐明APC蛋白表达率结合临床病理用于指导下一步的诊疗。方法选取2012年5月至2015年5月在浙大邵逸夫医院德清院区结肠镜下行EMR、ESD摘除的息肉患者13例、腺瘤伴癌前病变患者120例、腺癌患者17例,共150例。采用免疫组化检测并分析APC蛋白的表达率,同时记录该患者的临床、病理学参数。对患者进行随访(结合电话随访和住院门诊资料),统计其5年复发、癌变及后续治疗情况。统计APC蛋白在结直肠腺瘤发生发展阶段中阳性表达率,分析APC蛋白表达与患者临床、病理的关系。结果息肉、腺瘤伴低级别上皮内瘤变、腺瘤伴高级别上皮内瘤变、早期腺癌平均表达率分别为100.0%、92.7%、86.4%、58.8%。息肉、腺瘤伴癌前病变、早期腺癌APC蛋白表达率比较差异有统计学意义(P<0.05)。低级别、高级别上皮内瘤变APC蛋白表达率比较差异无统计学意义。结论在结直肠息肉-腺瘤伴癌前病变-早期癌变的进展序列中,APC蛋白的表达率也逐渐降低,并随着APC蛋白表达率的降低,结直肠息肉、腺瘤、早期癌变的复发率表现为跳跃状增加趋势。Objective To investigate the expression of APC protein in colorectal polyp-adenoma with precancerous lesions-early cancer progression sequence,to explore the relationship between APC protein expression and prognosis,tumor recurrence,and to clarify whether APC protein expression combined with clinical pathology can be used to guide the next diagnosis and treatment.Methods Collected 150 cases of polyps(n=13),adenomas with precancerous lesions(n=13)and early cancer(n=17)which were removed by ESD and EMR under colonoscopy from May 2012 to may2015 in Deqing Hospital of Shaw Run.The expression rate of APC protein was detected and analyzed by immunohistochemistry,and the clinical and pathological parameters of the patients were recorded.The patients were followed up(combined with telephone follow-up and outpatient data),and the recurrence,canceration and follow-up treatment in five years were counted.The positive expression rate of APC protein in colorectal adenoma was analyzed,and the relationship between APC protein expression and patients’clinical characteristics was analyzed.Results The average expression rates of polyps,adenomas with low-grade intraepithelial neoplasia,adenomas with high-grade intraepithelial neoplasia and early adenocarcinoma were 100.0%,92.7%,86.4%and 58.8%.The expression rate of APC protein in polyps,adenomas with precancerous lesions and early adenocarcinoma was significantly different(P<0.05).There was no significant difference in APC protein expression between low-grade and high-grade intraepithelial neoplasia.Conclusion In the progression sequence of colorectal polyp-adenoma with precancerous lesions-early carcinogenesis,the expression rate of APC protein decreased gradually,and with the decrease of the expression rate of APC protein,the recurrence rate of colorectal polyp,adenoma and early canceration showed an increasing trend.

关 键 词：APC蛋白 结直肠癌 结直肠癌前病变 

分 类 号：R735.34[医药卫生—肿瘤]