AAP蛋白表达对大肠癌术后复发转移风险的预测价值

目的:本研究旨在通过检测大肠癌患者组织和外周血中Anchor Attachment蛋白(anchor attachment protein，AAP)的表达对大肠癌(colorectal cancer，CRC)术后复发转移风险的预测价值及临床意义。方法:选取2013年1月至2013年12月武汉市第五医院收治的大肠癌患者107例，均行手术治疗，经病理组织学检查证实。采用免疫组织化学判定AAP阳性表达；ELISA法检测静脉血AAP水平；应用SPSS 18.0软件进行统计学分析，以复发转移为因变量将单因素分析中有统计学意义的影响因素带入Logistic回归模型中进行多因素分析。结果:AAP在大肠癌原发灶中阳性表达率均高于正常肠黏膜组织；此外，AAP阳性表达及其血清水平与性别、年龄、肿瘤位置和肿瘤最大直径均无关(P＞0.05)，与远处转移、淋巴结转移、分化程度、Dukes分期、浸润深度和TNM分期均密切相关(P＜0.05)；AAP表达及其血清水平与大肠癌患者术后3年发生局部复发、远处转移和复发转移有关(P＜0.05)，AAP表达为阳性的大肠癌患者根治术后复发转移的中位时间明显短于AAP表达阴性的大肠癌患者(P＜0.05)，Logistic回归分析结果显示大肠癌的组织分化和Dukes分期是大肠癌术后复发转移的危险因素(P＜0.05)。结论:AAP的表达与大肠癌复发和转移密切相关，对预测和判断大肠癌术后复发转移有重要意义和研究价值。

The predictive value of AAP protein in the recurrence and metastasis risk of colorectal cancer

Objective:To investigate the predictive value of anchor attachment protein(AAP) in the recurrence and metastasis of colorectal cancer(CRC) by detecting the expressions of AAP in CRC tissues and peripheral blood.Methods:From January 2013 to December 2013,totally 107 CRC patients were selected.all patients underwent surgical treatment and confirmed by histopathologic examination.The positive expression of AAP and the venous blood AAP level were detected by immunohistochemistry and ELISA,respectively.Statistical analysis was performed by the SPSS 18.0 software.Taking the recurrence and metastasis as the dependent variable,multi factor analysis was conducted by introducing the influencing factors which showed significant difference in single factor analysis.Results:The positive rate of AAP in primary CRC was higher than that in normal mucosa tissue.Additionally,the positive expression of AAP were independent of serum levels,gender,age,tumor location and the maximum diameter of tumor(P＞0.05),while it was associated with distant metastasis,lymph node metastasis(LNM),differentiation,Dukes stage,depth of invasion and TNM stage(P＜0.05).The expression and serum levels of AAP were related to local recurrence,distant metastasis and recurrence-metastasis for CRC patients at 3 years after treatment(P＜0.05).The median time of recurrence and metastasis for CRC patient with positive expression of AAP after radical correction was shorter than that in CRC patients with negative expression of AAP(P＜0.05).Logistic regression analysis results showed that tissue differentiation and Dukes stage were risk factors for postoperative recurrence and metastasis of CRC(P＜0.05).Conclusion:The expression of AAP is closely related to the recurrence and metastasis of CRC,which has important significance and research value for predicting and judging the postoperative recurrence and metastasis of CRC.