结直肠癌中CDX2、p21~(H-ras)、p21~(WAF1)表达的临床意义

背景:CDX2与肠源性肿瘤的发生密切相关,而p21表达减低或缺失可能是结直肠癌发生、发展中的一个普遍事件。目的:探讨结直肠癌中CDX2、p21~(H-ras)、p21~(WAF1)表达的相关性和临床病理意义。方法:收集45例临床病理资料完整的结直肠癌手术切除标本,以免疫组化方法检测癌组织和相应癌旁组织中的CDX2、p21~(H-ras)、p21~(WAF1)蛋白表达。结果:结直肠癌组织中CDX2、p21~(H-ras)、p21~(WAF1)阳性率分别为86.7%、68.9%和35.6%,相应癌旁组织中阳性率分别为100.0%、37.8%和51.1%,CDX2和p21~(H-ras)在癌组织和癌旁组织中的阳性率差异有统计学意义(P=0.026和P=0.006);半定量分析结果显示CDX2和p21~(WAF1)在癌组织和癌旁组织中的表达水平差异有统计学意义(P=0.007和P=0.005)。癌组织中CDX2与p21~(H-ras)的表达存在相关性(r_s=0.501,P=0.000)。Dukes A、B期患者癌组织p21~(WAF1)阳性率显著高于C、D期患者(P=0.016),有淋巴结转移者p21~(WAF1)阳性率显著低于无淋巴结转移者(P=0.048),CDX2、p21~(H-ras)的表达与结直肠癌各临床病理特征均无相关性。结论:CDX2、p21~(H-ras)、p21~(WAF1)表达改变可能与结直肠癌的发生、发展相关。

Clinical Significances of CDX2,p21H-rsa and p21WAF1 Expressions in Colorectal Cancer

Background： It has been reported that CDX2 is closely correlated with enterogenic tumors, and low-expression or absence of p21 may be a common event in the development of colorectal cancer. Aims： To investigate the correlations between expressions of CDX2, p21^H-ras and p21^WAF1 in colorectal cancer and their clinicopathologic significances. Methods： Forty-five pairs of cancerous and paracancerous specimens were collected from patients undergone colorectal cancer resection with complete clinicopathologic data. lmmunohistochemical method was used to determine the protein expressions of CDX2, p21^H-ras and p21^WAF1 in these specimens. Results： The positivity rates of CDX2, p21^H-ras and p21^WAF1 were 86.7%, 68.9% and 35.6% in the cancerous tissues and were 100.0%, 37.8% and 51.1% in the paired paracancerous tissues, respectively. The differences of the positivity rates of CDX2 and p21^H-ras in cancerous and paracancerous tissues were statistically significant （P=0.026 and P=0.006）. Semi-quantitative analysis showed that the expression levels of CDX2 and p21^WAF1 in cancerous and paracancerous tissues were significantly different （P=0.007 and P=0.005）. CDX2 expression was positively correlated with p21^H-ras in cancerous tissues （rs=0.501, P=0.000）. The positivity rate of p21^WAF1 in cancerous tissues of patients with Dukes stage A and B was significantly higher than those with Dukes stage C and D （P=0.016）, whereas the positivity rate of p21^WAF1 in patients with lymph node metastasis was significantly lower than those without （P= 0.048）. No relationships were found between CDX2, p21^H-ras expressions and the clinicopathologic features of colorectal cancer. Conclusions： Changes of expressions of CDX2, p21^H-ras and p21^WAF1 might be involved in the development of colorectal cancer.