MTS1/p16基因失活与大肠癌发生及患者生活质量的关系

背景本实验应用免疫组化及粘液组化方法观察MTS1/p16基因产物在大肠癌组织的表达情况 ,并与癌旁移行黏膜及正常黏膜进行了对比,了解患者的预后与生活质量.目的探讨 MTS1/p16基因失活与大肠癌发生的关系及对患者生活质量的意义.设计标准对照的实验研究. 地点和对象地点为中国医科大学附属第二医院外科,对象为 2000 01/2001 02住院大肠癌手术患者.男67例,女 43例,年龄 40～ 83岁.病程 1个月～ 1.5年,选取患者大肠癌及癌旁组织新鲜标本.方法应用免疫组化方法观察 MTS1/P16基因产物在 110例大肠癌组织的表达情况,并与非典型增生、癌旁移行粘膜及正常粘膜进行了比较.主要观察指标以细胞呈清晰棕色为阳性判断标准 ,按阳性细胞所占的比例分为+,阳性细胞数 < 25%;(++),阳性细胞数 25%～ 50%;(+++),阳性细胞数 >50%.以细胞无棕色或与背景一致的淡棕色为阴性.生活质量测定采用李凌江等编制的生活质量综合评定问卷.结果癌组织 p16阳性分级表达低于正常黏膜及移行黏膜( P< 0.05).在管状腺癌中,高分化22 例, p16阳性率 86%;中分化 43 例, p16阳性率 33%;低分化 7例, p16阳性率29%,高低分化癌之间差异有显著意义 (t=5.1, P< 0.01). 结论 p16蛋白的表达缺失与大肠癌的发生有关,并随着分化程度下降p16表达缺失增加.该指标对大肠癌患者病情的判定及疗效评价、恢复情况具有重要意义.

Effect of the gene MTS1/p16 inactivation on the carcinogenesis of the large intestine and the patient''''s life quality

BACKGROUND:The present experiment aimed at observing the expression of the products of the gene MTS1/p16 in the tissues of the carcinoma of large intestine,using immunohistochemical and mucin histochemical methods and compared with,transitional mucosa and the normal mucosa so as to learn about the patient's prognosis and life quality.OBJECTIVE:To explore the relationship between the inaction of the gene MTS1/p16 and the carcinogenesis of large intestine,and patients' life quality.DESIGN:Standard controlled trial.SETTING AND PARTICIPANTS:The experiment was carried out at the Laboratory for the Division of the Surgery of the Second Affiliated Hospital of China Medical University.The subjects,67 males and 43 females,aged from 40 to 83 years old(mean age 53± 15.3),were the inpatients that were hospitalized from 2000/01 to 2001/02.They suffered from the carcinoma of large intestine.The course of disease was 1 month to 1.5 years.The fresh specimen from the carcinoma of large intestines and the para cancerous tissues of the patients were taken.INTERVENTIONS: The expression of the gene products of MTS1/p16 in 110 cases of carcinoma of large intestines was observed by immunohistochemical method,and was compared with that in atypical dysplasia,and the transitional mucosa and the normal mucosa.MAIN OUTCOME MEASURES:When the cell appears clear brown, it is positive,and it is taken as the standard for judging if a cell is positive.Then,when the cell doesn't show brown,or light brown that is the same as the background,it is negative,and it is taken as the standard for judging if a a cell is negative.According to the number of the positive cells,they can be divided into the following:+ :the positive cells < 25 % , ;(++):the positive cells,25 % ( 50 % ;(+++):the positive cells >50 % .The determination of life quality was decided according to the Comprehensive Evaluation Questionnaire for Life Quality by Ling Jiang Li.RESULTS:The grading positive expression of p16 in cancerous tissues was lower than that in normal mucosa and transitional mucosa (P< 0.05).In tubular adenocarcinoma,22 cases belonged to the group of high differentiation, and the positive rat was 86 % ;43 cases to the group of medium differentiation,and the positive rate was 33 % ;7 cases to the group of low differentiation, and the positive rate was 29 % . The difference between high and low differentiation of cancer was significant(t=5.1, P< 0.01).CONCLUSIONS:The inactivation of p16 gene expression is related to the carcinogenesis of large intestines,and with the lowering of differentiation, the inactivation of p16 expression was increased.This index plays an important role in judging the status quo of the carcinoma of large intestines,the curative effect,and the rehabilitation of the patient.