MSH6、CDX2在早期结直肠癌中的表达及其临床意义

目的探讨蛋白Muts同源6基因（MSH6）、基因系尾型同源盒基因（CDX2）在结直肠癌（CRC）中表达水平及与预后的关系。方法回顾性分析手术治疗的269例早期（Ⅰ、Ⅱ）CRC患者的临床资料,其中资料完整且有随访数据的患者113例做为研究对象。应用免疫组织化学SP法检测患者肿瘤组织中MSH6及CDX2的表达水平,应用COX模型多因素回归分析MSH6及CDX2的表达水平、患者性别、年龄、病理类型、临床分期、淋巴结转移等临床特征与预后的相关性。结果患者中MSH6阳性率为70.8%,CDX2阳性率为79.6%;单因素分析显示,CDX2表达与患者的肿瘤大小（P=0.04）和分化程度有关（P〈0.05）,MSH6表达与上述临床特征无关（P〉0.05）;中位生存期为（71.5±6.2）个月,COX回归分析显示,患者预后与病理分级（P〈0.05）和CDX2表达水平（P〈0.05）有关。结论 CDX2表达降低、病理分级较低是早期CRC预后不良的危险因素。

Clinical significance and expression of MSH6 and CDX2 in early colorectal cancer

Objective To evaluate the relationship between MSH6 and CDX2 expression and the prognosis in patients with early colorectal cancer. Methods 113 patients with early colorectal cancer were retrospective analyzed. The expression level of MSH6 and CDX2 were analyzed by immunohistochemistry in 113 subjects. The relationship between MSH6 and CDX2 expression,clinical characteristics and prognosis were analyzed by using the Cox regression model. Results The positive rates were 70. 8% and 79. 6% in MSH6 and CDX2,respectively. CDX2 expression status was associated with the tumor size（ P 0. 05） and pathology grade（ P 0. 05）. But no association was observed between MSH6 expression and the patients clinical characteristics（ P 0. 05）. The median survival time was 71. 5 ± 6. 2 months in this group. The Cox regression model analysis demonstrated that the prognosis of early colorectal cancer was associated with pathological grade（ P 0. 05） and CDX2 expression status（ P 0. 05）. Conclusion The CDX2 loss expression and lower pathological grade is associated with poor prognosis in patients with early colorectal cancer.