组织中环氧化酶-2蛋白在进展期结直肠腺瘤雪白征中的表达  

Expression of Cyclooxygenase-2 in Patients With Snow-White Sign of Advanced Colorectal Adenomas

作　　者：高建丽 王学红 马臻棋 杨生森 石宏斌 GAO Jianli;WANG Xuehong;MA Zhenqi;YANG Shengsen;SHI Hongbin(Graduate School of Qinghai University,Xining 810016,China;Department of Gastroenterology,Affiliated Hospital of Qinghai University,Xining 810000,China)

机构地区：[1]青海大学研究生院,西宁810016 [2]青海大学附属医院消化内科,西宁810000

出　　处：《中国医学科学院学报》2023年第4期591-596,共6页Acta Academiae Medicinae Sinicae

基　　金：青海大学附属医院重点专科项目(2019-233号、2019-195号)。

摘　　要：目的分析组织中环氧化酶-2(COX-2)蛋白在进展期结直肠腺瘤(ACA)雪白征中的表达情况,探讨雪白征相关临床意义。方法采用Western blot方法分别检测雪白征阳性组和阴性组(每组40例)ACA患者腺瘤组织和瘤旁正常组织(距瘤组织远端>5 cm)COX-2蛋白的表达情况。结果雪白征阳性ACA患者在不同年龄差异有统计学意义(P=0.001),而在不同性别、吸烟与否、饮酒与否、不同民族、有无结直肠癌家族史、有无腹痛、有无腹泻、有无便秘、有无便潜血、肿瘤标志物是否正常方面差异均无统计学意义(P均>0.05)。雪白征阳性ACA多见于多发腺瘤(P=0.004)、较大腺瘤(P=0.006)、远端结肠(P=0.015)、突出型息肉(P=0.044)及晚期病理(P=0.010),雪白征阳性ACA在日本窄带成像技术专家小组分型差异无统计学意义(P=0.502)。雪白征阳性和阴性组腺瘤组织COX-2蛋白表达显著高于瘤旁正常组织(P<0.001,P=0.004),雪白征阳性组腺瘤组织COX-2蛋白表达显著高于雪白征阴性组(P=0.001),两组瘤旁正常组织COX-2蛋白表达差异无统计学意义(P=0.603)。结论雪白征阳性ACA多见于年龄较小、多发及较大腺瘤、远端结肠、突出型息肉及晚期病理。雪白征阳性ACA中COX-2蛋白表达显著高于雪白征阴性ACA,成人伴有雪白征的腺瘤比无雪白征的腺瘤容易癌变,具有更高的致癌风险。Objective To analyze the expression of cyclooxygenase-2(COX-2)in the patients with snow-white sign of advanced colorectal adenoma(ACA)and explore its clinical significance.Method Western blotting was employed to determine the expression of COX-2 in the adenoma tissue and the normal tissue adjacent to the adenoma tissue(>5 cm away from the distal end of the adenoma tissue)of 40 ACA patients with snow-white sign and 40 ACA patients without snow-white sign.Results The appearance of snow-white sign in ACA patients was associated with patient age(P=0.001)and not associated with sex,smoking history,drinking history,ethnic groups,family history of colorectal cancer,abdominal pain,diarrhea,constipation,fecal occult blood,or tumor markers(all P>0.05).Snow-white sign mainly appeared in the ACA patients with multiple adenomas(P=0.004),large adenomas(P=0.006),adenomas in distal colon(P=0.015),protruding polyps(P=0.044),and late-stage pathology(P=0.010).The occurrence of snow-white sign showed no difference in the ACA patients with different results of Japan NBI Expert Team classification(P=0.502).The expression of COX-2 in the adenoma tissue was higher than that in the adjacent normal tissue in the patients with and without snow-white sign(P<0.001,P=0.004).The patients with snow-white sign had higher expression of COX-2 protein in the adenoma tissue than the patients without snow-white sign(P=0.001).The expression of COX-2 protein in the adjacent healthy tissue had no significant difference between the patients with and without snow-white sign(P=0.603).Conclusions Snow-white sign is more like to appear in the ACA patients with young age,multiple and large adenomas,adenomas in distal colon,protruding polyps,and late-stage pathology.Moreover,the expression of COX-2 in the ACA patients with snow-white sign is significantly higher than that in the ACA patients without snow-white sign.The adults with snow-white sign are prone to cancerization than those without snow-white sign.

关 键 词：雪白征 鸡皮样黏膜 环氧化酶-2蛋白 进展期腺瘤 结直肠肿瘤 

分 类 号：R574.62[医药卫生—消化系统] R574.63[医药卫生—内科学]