摘要
背景:研究表明,结直肠癌的主要发病途径有两条,即染色体不稳定性途径和微卫星不稳定性(MSI)途径。目的:探讨错配修复蛋白(MMRP)和p53蛋白在结直肠癌中的表达及其临床意义。方法:采用免疫组化SP法检测2013年1月—2017年12月上海市嘉定区中心医院收治的276例结直肠癌中4种MMRP和p53蛋白表达,并分析其与临床病理特征的关系。分析MSI对结直肠癌患者生存情况的影响。结果:MMRP表达缺失36例(13.0%),MSI与组织病理学类型、TNM分期和血吸虫感染有关(P<0.05),而与患者性别、年龄、发病部位、分化程度和淋巴结转移均无关(P>0.05)。p53蛋白在结直肠癌中的阳性表达率为44.9%,其表达与组织病理学类型、TNM分期、淋巴结转移和血吸虫感染有关(P<0.05),而与患者性别、年龄、发病部位和分化程度均无关(P>0.05)。MSI与p53表达呈负相关(r=-0.169,P<0.05)。MSI组和MSS组的1、3、5年生存率分别为100%、97.2%、83.1%和96.7%、81.9%、38.9%,差异有统计学意义(χ^2=12.582,P=0.001)。结论:MSI和p53表达与结直肠癌的临床病理特征关系密切,对肿瘤的恶性程度和预后的判断有指导意义。MSI与p53表达呈负相关,提示两者可能参与结直肠癌不同阶段的发生、发展过程。
Background:Studies have indicated that there are two main pathogenetic pathways of colorectal cancer,chromosomal instability pathway and microsatellite instability(MSI)pathway.Aims:To investigate the expressions and clinical significance of mismatch repair protein(MMRP)and p53 protein in colorectal cancer.Methods:Immunohistochemical SP staining was used to detect the expressions of 4 MMRP and p53 protein in 276 colorectal cancer patients from Jan.2013 to Dec.2017 at Jiading Central Hospital of Shanghai,and their relationships with clinicopathological features were analyzed.The influence of MSI on survival rate of patients with colorectal cancer was analyzed.Results:The deficit of expression rate of MMRP was 13.0%.MSI was associated with histological type,TNM staging,Schistosomiasis infection(P<0.05),but not with gender,age,tumor location,differentiation,lymph node metastasis(P>0.05).The positivity expression rate of p53 was 44.9%,and the expression was correlated with histological type,TNM staging,lymph node metastasis,Schistosomiasis infection(P<0.05),but not with gender,age,tumor location,differentiation(P>0.05).MSI was negatively correlated with p53 expression(r=-0.169,P<0.05).The 1-,3-,5-year survival rates in MSI group and MSS group were 100%,97.2%,83.1% and 96.7%,81.9%,38.9%,respectively,and the difference was statistically significant(χ^2=12.582,P=0.001).Conclusions:MSI and p53 are closely related to the clinicopathological features of colorectal cancer,and have some values in predicting the degree of malignancy and prognosis of colorectal cancer.MSI is negatively correlated with p53 expression,which indicates that the two may participate in different stages of development and progress of colorectal cancer.
作者
刘菊林
李静
陈军
卢国丰
王红霞
杨荣
LIU Julin;LI Jing;CHEN Jun;LU Guofeng;WANG Hongxia;YANG Rong(Department of Pathology,Jiading Central Hospital,Shanghai University of Medicine&Health Sciences,Shanghai,201800)
出处
《胃肠病学》
2020年第1期28-32,共5页
Chinese Journal of Gastroenterology
关键词
结直肠肿瘤
错配修复蛋白
P53
微卫星不稳定性
Colorectal Neoplasms
Mismatch Repair Proteins
p53
Microsatellite Instability
