摘要
目的探讨不同病理分型肠息肉与肿瘤发生相关的干细胞标志Lgr5和CD44的表达及其对息肉癌变的临床预测意义。方法经结肠镜活检获取结肠直肠息肉、腺瘤和癌组织145例,进行病理检测分型;应用免疫组化方法检测不同病理类型标本中肿瘤干细胞标志Lgr5和CD44的表达,分析比较其与结、直癌的发生和预后的关系。结果 CD44在结肠癌组织中的表达率为95.65%,显著高于正常粘膜5%、炎性增生性息肉22.58%、管状腺瘤性息肉55.26%及绒毛状息肉75.76%(P<0.05)。Lgr5在大肠癌组织中的表达高达95.65%(22/23),显著高于正常粘膜(无表达)和炎性增生息肉16.12%(P<0.05),而在管状腺瘤和绒毛状腺瘤中表达分别为86.84%(33/38)和93.94%(31/33),与大肠癌相比,两两差异不具有统计学意义(P>0.05)。相关性分析结果显示,CD44、Lgr5的表达强度与肠息肉癌变进展均呈正相关(rs=0.69377,P<0.0001;rs=0.81637,P<0.0001)。结论 Lgr5和CD44在大肠癌癌组织中高表达,它们的高表达与临床和病理的特征具有显著相关性;Lgr5和CD44的表达是区别大肠癌癌组织与正常肠粘膜组织的显著特点;与CD44相比,Lgr5表达与息肉癌变具有较强相关性,联合检测Lgr5与CD44在肠道早期病变诊断、尤其是肠息肉癌变预测中具有重要意义。
Objective To study the expression of tumorigenesis-related stem cell markers Lgr5 and CD44 in different pathological types of intestinal polyps and their clinical significance in predicting tumorigenesis. Methods A total of 145 cases of colorectal polyps, adenomas and cancer tissues were obtained by colonoscopy biopsy. Immunohistochemistry was employed to detect the expression of Lgr5 and CD44 to analyze their relationship with the occurrence and prognosis of colon and rectal cancer. Results The expression of CD44 in colon cancer tissue was 95.65% , significantly higher than that in normal mucosa （5% ）, inflammatory hyperplastic polyps （22.58%）, tubular adenomatous polyps （55.26%） and villous polyps （75.76%） （P0.05）. The expression of Lgr5 in colorectal cancer was up to 95.65% while negative in normal colorectal tissue and was 16.12% in inflammatory hyperplastic tissues （P0.05）. The expression rate of Lgr5 was 86.84% in tubular adenoma and 93.94% in villous polyps, both comparable with that in colon cancer （P0.05）. Correlation analysis indicated that the expression of CD44 and Lgr5 were positively correlated with the progression of intestinal polyp tumorigenesis （r s =0.69377, P0.0001; r s =0.81637, P 0.0001）. Conclusion Lgr5 and CD44 are highly expressed in colorectal cancer tissues in close correlation with the clinical and pathological features. The expression profiles of Lgr5 and CD44 represent a distinct feature to differentiate colorectal cancer from normal intestinal mucosa. Lgr5 is more closely correlated with tumor progression of polyps than CD44. This means detecting of the expression of Lgr 5 together with CD44 is important and necessary in clinical diagnosis of patients with early stage colorectal diseases such as polyps and their canceration.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2013年第7期972-976,共5页
Journal of Southern Medical University
基金
国家自然科学基金(81072913)~~
