溃疡性结肠炎相关结直肠癌临床特点及癌变相关蛋白的表达

目的 探讨溃疡性结肠炎(UC)相关结直肠癌的临床特点及其癌变的可能机制.方法 收集北京协和医院1984年至2008年6例UC相关性结直肠癌,分析其发病情况、临床表现、病理类型、治疗及预后特点,免疫组化检测组织标本中结肠腺瘤性息肉蛋白(APC蛋白)、β-连环蛋白、p53蛋白和Wnt1蛋白表达的情况.结果 UC的癌变率为1.1%(6/534),女性多见(5/6),平均病程14.3年.临床均呈现典型的UC表现,病变常累及全结肠(5/6),均无原发性硬化性胆管炎.其中直肠癌4例、降结肠癌2例,病理类型以腺癌为主,预后较差.APC蛋白、β-连环蛋白、p53蛋白和wnt1蛋白表达的阳性率分别为6/6、6/6、5/6和6/6.结论 临床对病变累及全结肠、病程长的UC患者,应注意防止结直肠癌的发生,其癌变过程可能有多途径参与.

Clinical characters of ulcerative colitis associated colorectal cancer and carcinogenesis related protein expression

Objective To explore the clinical features and possible carcinogenesis mechanism of the ulcerative colitis (UC)-associated colorectal cancer. Methods From 1984 to 2008, 6 clinical cases of UC-associated colorectal cancer were collected at Peking Union Medical College Hospital. The characters of morbidity, clinical features, pathology type, treatment and prognosis were analyzed.Immunohistochemistry(IHC) was performed to study the protein expression of adenomatous polyposis coli protein(APC), β-catenin, P53 and Wnt-1 in the specimens. Results The canceration of UC was 1.1 %, higher in female cases (5/6), the average duration was 14.3 years. All cases presented typical UC manifestation, most involved total colon (5/6) and none of them complicated with primary sclerosing cholangitis (PSC). There were 4 rectal cancers and 2 descending colon caners the UC cases collected. The major pathology type was adenocarcinoma with poor prognosis. The positive protein expression ratio of APC, β-catenin, P53 and Wnt-1 were 6/6, 6/6, 5/6 and 6/6 respectively.Conclusion The rectal cancer should be monitored and prevented in UC patients with total colon involved and long disease duration. Multi-pathway may possibly be involved in the carcinogenesis.