CD4、CD8、MSI表达与散发性结直肠癌预后关系的研究

目的探讨CD4、CD8与微卫星不稳定性（MSI）表达对散发性结直肠癌（SCRC）预后判断的价值。方法对50例SCRC手术标本,采用免疫组织化学SP法检测CD4、CD8,采用PCR-SSCP法检测SCRC组织中MSI表达。结果 50例SCRC中CD4和CD8表达均较相应的癌旁正常组织强,差异有显著性（P〈0.05）。50例SCRC患者术后5年生存率为48%。按CD4和CD8表达强弱分组,CD4（＋）和CD8（＋）组术后5年累积生存率分别高于CD4（-）和CD8（-）组,但差异无显著意义（P〉0.05）。当分成CD4/8（＋/＋）CD4/8（＋）]、CD4/8（＋/-）、CD4/8（-/＋）、CD4/8（-/-）CD4/8（-）]四组,则CD4/8（＋）组的5年累积生存率高于CD4/8（-）,差异有显著性（P〈0.05）。经Spearman等级相关分析显示,SCRC组织中CD4/8（＋/＋）表达与MSI（＋）表达密切相关（P〈0.01）,而与MSI（-）表达无相关性（P〉0.05）。结论散发性结直肠癌组织中有CD4和CD8呈阳性表达。CD4/8（＋）表达与MSI表达有同向关系。CD4/8和MSI表达均可作为散发性直肠癌预后的辅助判断指标。

The Study of the Protein Expression on CD4,CD8 and MSI and Correlation with the Prognosis in Sporadic Colorectal Carcinoma

Objective To study the prognostic value of the expression of CD4,CD8 and MSI in sporadic colorectal carcinoma（SCRC）.Methods The expression of CD4 and CD8 was detected by immunohistochemical SP method,and the expression of MSI was examined by using the PCR-SSCP in the surgical specimens from 50 patients with sporadic colorectal carcinoma.Results The positive expression rate of CD4 and CD8 was significantly higher in the cancerous tissues than that in the para-cancerous tissues（P 0.05）.The five year survive rate of the 50 patients was 48%.The 5 year survival rate of the patients with CD4 ＋ and CD8 ＋ was higher than that with CD4（-） and CD8（-）,but without significant difference（P 0.05）.When the patients were divided into the CD4/8（＋） group,the patients with positive expression of both CD4 and CD8,and the CD4/8（-） group,patients with positive expression of either CD4 or CD8,or with negative expression of CD4 and CD8,there was significantly higher survival rate in CD4/8（＋） group.（P 0.05）.The expression of CD4/8（＋） had significant relationship with MSI（＋）（P 0.01）,but not with MSI（-）.Conclusion There are positive expression of CD4 and CD8 in some SCRC.The expression of CD4/8（＋） had cocurrent relationship with the expression of MSI.The expression of CD4/8（＋） and MSI both can be used as supplement judgment standard for the prognosis of SCRC.