结直肠癌CK7阳性表达的临床病理学意义

目的 探讨CK7阳性表达在结直肠癌的临床病理学意义.方法 应用免疫组织化学SP法检测CK7、CK20在68例结直肠癌、20例管状腺瘤、5例锯齿状腺瘤和20例增生性息肉的表达.结果 68例直结肠癌CK20表达阳性率89.7%;CK7表达阳性率39.7%,其中结肠癌阳性率35.7%(15/42),直肠癌42.3%(11/26);管状腺瘤CK20表达阳性率100%,CK7表达阴性;锯齿状腺瘤和腺瘤增生性息肉CK20表达阳性率100%,CK7表达阳性率分别为40%和30%.在结肠癌,CK7阳性表达与Dukes'分期、腺癌分化程度及发生部位无明显相关性.结论 CK7很可能是增生性息肉-锯齿状腺瘤-癌变途径发生的结直肠癌标志物之一,检测结直肠粘膜息肉样变CK7的表达,可能对判断结肠息肉癌变具有重要意义.

Clinicopathological implications of positive CK7 expression in colorectal carcinoma

Objective To investigate the clinicopathological significance of positive CK7 expression in human colorectal carcinoma(HCC).Methods Immunohistochemistry was used to detect CK7 and CK20 protein expressions in 68 cases of HCC,20 cases of canalicular adenoma(CA),5 cases of serrated adenoma(SA)and 20 cases of hyperplastic polyps(HP).Results The positivity rate of CK20 expression was 89.7% in HCC,and 100% in CA,SA and HP.In HCC,the expression rate of CK7(39.7%)was not correlated with Dukes' classification,differentiation and tumor location.CK7 positivity rate in colon cancer was 35.7%(15/52)and 42.3%(11/26)in rectal cancer.CK7 expression was negative in CA.CK7 positivity rate in SA was 49% and 30% in HP.Conclusion CK7 is a possible marker for colorectal carcinogenesis from HP to SA,and ultimately to HCC,and examination of the colorectal polypoid lesions for CK7 expression can be significant for estimating the colorectal polypous cancerization.