Snail在大肠肿瘤组织中的表达及其意义

目的探讨Snail蛋白表达在大肠癌的发生发展中的作用及意义。方法用免疫组化方法检测145例大肠石蜡标本的Snail表达。病例包括大肠炎25例、腺瘤40例、腺癌40例、转移性腺癌40例。结果依大肠炎、腺瘤、腺癌、转移性腺癌的次序,Snail阳性表达率分别为16.0%、67.5%、75.0%、95.0%,其中大肠炎组分别与其他三组比较,差异有统计学意义（P〈0.05或P〈0.01）;腺瘤组与腺癌组比较,差异无统计学意义（P〉0.05）;腺瘤组和腺癌组分别与转移性腺癌组比较,差异有高度统计学意义（P〈0.01）。依Ⅰ、Ⅱ、Ⅲ、Ⅳ临床分期次序,Snail阳性表达率分别为50.0%、62.1%、93.1%、95.0%,经比较,差异有高度统计学意义（P〈0.01）。直肠癌和结肠癌的Snail阳性表达率分别为100.0%和67.4%,经比较,差异有高度统计学意义（P〈0.01）。Snail阳性表达与性别、年龄、浸润深度、分化程度等无关。Snail阳性表达从大肠炎中诊断腺瘤的敏感性为67.5%,特异性为84.0%;从腺瘤中诊断腺癌的敏感性为85.0%,特异性为32.5%。结论 Snail在大肠黏膜演变成腺瘤和腺癌、从未转移性腺癌演变成转移性腺癌、从早期癌到晚期癌中表达显著升高,提示Snail可以促进大肠肿瘤的发生发展。

The expression and expression significance of Snail in colorectal tumors

Objective To explore the expression and role of Snail in occurrence and development of colorectal tumors.Methods Immunohistochemistry was used to detect the Snail expression in 145 cases of colorectal tissues.The cases included 25 cases of colitis,40 cases of adenomas,40 cases of adenocarcinomas and 40 cases of metastatic adeno carcinomas.Results In the order of colitis,adenoma,adenocarcinoma and metastatic adenocarcinoma,the Snail ex pression rates were 16.0%,67.5%,75.0%,95.0%,respectively,the comparison had significant different（P〈0.05 or P〈0.01） between colitis and the three tumor groups,the comparison had no significant different（P〈0.05） between adenoma and adenocarcinoma,and the comparison had significant different（P〈0.01） between adenoma and adenocarcinoma and metastatic adenocarcinoma.In the order of the clinical phase Ⅰ,Ⅱ,Ⅲ and Ⅳ of the malignancies,the expression rates of Snail were 50.0%,62.1%,93.1%,95.0%,respectively,the comparison had significant different（P〈0.01）.The expression rates of Snail in the rectal carcinoma and colon carcinoma were 100.0% and 67.4%,respectively,the comparison had significant different（P〈0.01）.There was no significant difference between the expression of Snail and the age and gender of the patients,and invasive deepness and differentiation of the malignancies.For the Snail expres sion to diagnose adenoma from colitis,the sensitivity was 67.5% and the specificity was 84.0%.For the Snail expres sion to diagnose adenocarcinoma from adenoma,the sensitivity was 85.0% and the specificity was 32.5%.Conclusion The expression of Snail significantly increases during the evolution from colitis to adenoma and then adenocarcinoma,from adenocarcinoma to metastatic adenocarcinoma,and from the early phase to the late phase of colorectal carcinoma.The result indicated that Snail may initiate and promote cololectal adenocarcinoma.