TFF1和TFF3在结直肠癌中的表达与临床病理特点及预后的关系

  目的  检测三叶因子1（trefoil factor，TFF1）和三叶因子3（TFF3）在结直肠癌组织、癌旁组织及转移淋巴结中的表达，评价其与肿瘤发生、转移和预后的关系。  方法  采用免疫组织化学SP法检测65例结直肠癌、30例癌旁组织、25例转移淋巴结中TFF1和TFF3的表达，分析二者表达的差异及其与临床病理特征和预后的关系。  结果  TFF1在癌旁组织、癌组织和转移淋巴结中表达逐渐增高（26.7%，70.8%，96%，两两比较均P < 0.05）。癌组织和转移淋巴结与癌旁组织比较，TFF3表达率均有降低（100% vs. 84.6%或80%，均P < 0.05），癌组织和转移淋巴结之间差异无统计学意义（P>0.05）。TFF1在结直肠癌中的表达仅与肿瘤分化程度相关（P < 0.05）；TFF3表达与淋巴结转移及TNM分期有关（均P < 0.05）。TFF1在结直肠癌中的表达与TFF3呈负相关（P=0.014，r=-0.291）。TFF1表达水平与总生存率无相关性（P=0.639），而TFF3表达水平与总生存率有关（P=0.045）。Cox比例风险模型单因素分析显示，浸润深度、淋巴结转移、远处转移、TNM分期等为影响预后的相关因素。多因素分析显示，淋巴结转移、远处转移、TNM分期和TFF3为预后的影响因素。  结论  TFF1和TFF3表达率与结直肠癌的发生、转移和预后密切相关。两者可能在结直肠癌的侵袭、转移中存在共同作用，相互影响。 

TFF1 and TFF3 expressions in colorectal cancer and their relationship with clinicopathological characteristics and prognosis

  Objective  To detect the TFF1 and TFF3 expressions in colorectal cancer tissue, adjacent normal tissue, and lymph node metastases, and to evaluate their relationship with tumor occurrence and metastasis.  Methods  The expressions of TFF1 and TFF3 were detected by immunohistochemistry (SP method) in 30 adjacent normal colorectal mucosa specimens, 65 colorectal adenocarcinoma specimens, and 25 metastatic lymph node specimens. The differences in the expression of TFF1 and TFF3 in different tissues were compared, and their correlation with the clinicopathological features and survival were analyzed.  Results  The expression of TFF1 gradually increased along with the sequence of colorectal cancer tissue, adjacent normal tissue, and lymph node metastases (26.7%, 70.8%, and 96%, respectively; P < 0.05 in pairwise comparison). Unlike in normal adjacent tissue, the expressions of TFF1 decreased in colorectal cancer or metastatic lymph node (100% vs. 84.6% or 80%, P < 0.05). No statistical significance was observed between colorectal cancer and metastatic lymph node (P>0.05). Only differentiation related to TFF1 expression was observed (P < 0.05). TFF3 expression was associated with lymph node metastasis and TNM staging (P < 0.05). A negative correlation was found between TFF3 and TFF1 expressions in colorectal cancer (r=-0.291, P=0.014). No association was found between the TFF1 expression levels and overall survival (P= 0.639), whereas the TFF3 expression level was correlated with survival (P=0.045). The Cox proportional hazards model showed that infiltration depth, lymph node metastasis, distant metastasis, and pathological staging were the related factors affecting the prognosis through univariate analysis. The multivariate analysis demonstrated that lymph node metastasis, distant metastasis, pathological staging, and TFF3 were the influencing factors of prognosis.  Conclusion  TFF1 and TFF3 expressions are closely related to the incidence, metastasis, and prognosis of colorectal cancer. Both can function together in the invasion and the metastasis of colorectal cancer.