大肠癌免疫组化表达与临床病理的关系

目的:探讨大肠癌CEA、P53、nm23、Ki-67、MRP免疫组化表达特点和相互关系,及其与临床病理的关系．方法:回顾性分析2003-01／2006-07我院收治的73例大肠癌患者的临床病理及随访资料,并对其石蜡标本采用免疫组化SP染色法检测CEA、P53、nm23、Ki-67、MRP,分析其免疫组化特点及其与临床病理之间的关系．结果:CEA、P53、nm23、Ki-67、MRP在大肠癌中的阳性表达率依次为82．2％、68．5％、75.3％、84．9％和64．4％．CEA、MRP与大肠癌患者的各因素无统计学差异．P53、Ki-67和nm23与肿瘤的Dukes分期和淋巴结转移有关, P53、Ki-67在Dukes C、D期的阳性表达率(依次为82．8％和100％1明显高于Dukes A、B期者(59．1％和75．0％)(P<0．05),而nm23在Dukes C、D期的阳性表达率(58．6％)明显低于Dukes A、B期者(86．4％)(P<0．05)．CEA与nm23的表达呈明显的负相关(r=-0．296,P=0．011),而P53和Ki-67表达之间呈现明显的正相关(r= 0．308,P=0．008),其他各指标间的表达无相关性．nm23、P53和Ki-67与预后因素关系明显,nm23在生存期≥3 a患者的阳性表达率(92．9%)高于生存期<3 a者(71．2％)(P<0．05),而P53和Ki-67在生存期≥3 a患者的阳性表达率(依次为42．9％和64.3％)明显低于生存期<3 a者(74．6％和89．8％)(P<0．05)．结论:P53、Ki-67和nm23的表达与大肠癌的侵袭转移和预后密切相关．CEA可能是大肠癌的侵袭转移的促进因素．MRP所引起的耐药机制是一个相对独立的机制．CEA、P53、nm23、Ki-67可作为判断大肠癌恶性程度、侵袭转移以及预后的指标．

Immunohistochemical expression of carcinoembryonic antigen, P53, nm23, Ki-67, multidrug resistance-associated protein and their correlations with the clinicopathology in colorectal carcinoma

AIM: To investigate the mechanism of cyclooxygenase-2 (COX-2), basic fibroblast growth factor (bFGF) in the carcinogenesis of colorectal carcinoma and adenoma. METHODS: The expression of CEA, P53, nm23, Ki-67 and MRP protein were detected by SP immunohistochemistry in colorectal carcinoma (n = 73) admitted from January 2003 to July 2006, and their clinical data and follow-up documents were analyzed retrospectively. RESULTS: The positive rates of CEA, P53, nm23, Ki-67 and MRP protein expression in colorectal cancer were 82.2%, 68.5%, 75.3%, 84.9% and 64.4%, respectively. CEA and MRP expression had no correlations with the patients' ages, sex, tumor size or location and differentiation types of tumor, depth of invasion and lymph node metastasis, while P53, Ki-67 and nm23 expression were significantly correlated with the depth of invasion and lymph node metastasis. The positive rates of P53 and Ki-67 expression was significantly higher in Dukes C, D stages than those in Dukes A, B stages (82.8% vs 59.1%, P < 0.05; 100% vs 75.0%, P < 0.05), while the positive rate of nm23 expression was markedly lower (58.6% vs 86.4%, P < 0.05). The expression of CEA had a negative correlations with that of nm23 (r = -0.296, P = 0.011) in colorectal carcinoma. However, the expression of P53 had a positive correlations with that of Ki-67 (r = 0.308, P = 0.008). P53, Ki-67 and nm23 expression were significantly related to the prognosis. The positive rate of nm23 expression was notably higher in patients survived over or equal to 3 years than that in ones survived less than 3 years (92.9% vs 71.2%, P < 0.05), but the positive rates of P53 and Ki-67 expression were just in the opposite situation (42.9% vs 74.6%, P < 0.05; 64.3% vs 89.8%, P < 0.05). CONCLUSION: P53, Ki-67 and nm23 were significantly correlated with the invasion, metastasis and prognosis of colorectal carcinoma. CEA may be a stimulative factor in the invasion and metastasis of colorectal cancer and MRP-induced drug resistance may be relatively independent. CEA, P53, nm23 and Ki-67 can serve as effective markers ini reflecting the invasion, metastasis and prognosis of colorectal carcinoma.