盐诱导激酶2与结直肠癌伴慢性血吸虫病淋巴结转移的相关性研究

目的：探究慢性血吸虫病影响结直肠癌的发生发展是否与盐诱导激酶2（SIK2）相关。方法：标本来自于2015年6月至2020年6月在芜湖市第二人民医院就诊并经临床和病理检查诊断为结直肠癌的363例手术患者，其中结直肠癌伴慢性血吸虫病（CRC-S）患者56例，结直肠癌不伴慢性血吸虫病（CRC-NS）患者307例。对患者临床资料和病理诊断结果进行统计，分析慢性血吸虫病与结直肠癌的相关性。利用免疫组化和蛋白质印迹法检测SIK2在各组结直肠癌标本中的分布和表达情况，分析SIK2与CRC-S患者肿瘤淋巴结转移的相关性。结果：CRC-S组淋巴结转移率（62.5%）高于CRC-NS组（47.2%）（P<0.05）。CRC-S伴淋巴结转移患者血吸虫卵主要分布在肿瘤组织（25/35，71.4%），CRC-S不伴淋巴结转移患者血吸虫卵主要分布在癌旁组织（17/21，81.0%），差异有统计学意义（χ²=14.243，P<0.01）。SIK2主要位于胞质溶胶，其在肿瘤组织中的表达高于癌旁组织。与CRC-NS组比较，CRC-S组SIK2表达显著增加，且伴淋巴结转移的患者SIK2表达水平高于不伴淋巴结转移的患者，虫卵位于肿瘤组织的患者SIK2表达水平高于虫卵位于癌旁组织的患者（均P<0.01）。结论：CRC-S患者淋巴结转移率更高，且虫卵位于肿瘤组织时，更容易发生淋巴结转移。SIK2的表达水平与是否伴发慢性血吸虫病、虫卵分布部位以及淋巴转移具有相关性。

Relationship between salt-inducible kinase 2 (SIK2) and lymph node metastasis in colorectal cancer patients complicated with chronic schistosomiasis

Objective:To investigate the relationship between salt-inducible kinase 2 (SIK2) and lymph node metastasis in colorectal cancer patients complicated with chronic schistosomiasis. Methods:Tissue specimens were collected from 363 patients who were diagnosed as colorectal cancer by clinical and pathological examination in Wuhu Second People’s Hospital from June 2015 to June 2020. Fifty-six patients were colorectal cancer complicated with schistosomiasis (CRC-S) and 307 patients were colorectal cancer not complicated with schistosomiasis (CRC-NS). The clinical and pathological data of the patients were analyzed to explore the relationship between chronic schistosomiasis and colorectal cancer. Immunohistochemistry and Western blotting were used to detect the distribution and expression of SIK2 in colorectal cancer specimens. The relationship between SIK2 and lymph node metastasis of CRC-S was analyzed. Results:The rate of lymph node metastasis in CRC-S group was significantly higher than that in CRC-NS group (62.5% vs. 47.2%, P<0.05). In CRC-S patients with lymph node metastasis, schistosome eggs were distributed mainly in tumor tissues (25/35, 71.4%), while in patients with CRC-S without lymph node metastasis, schistosome eggs were distributed mainly in paracancerous tissues (17/21, 81.0%) (χ²=14.243, P<0.01). The SIK2 was mainly located in cytosol, and its expression in tumor tissues was higher than that in paracancerous tissues. Compared with CRC-NS patients, the expression of SIK2 in CRC-S patients was significantly increased; the expression of SIK2 in patients with lymph node metastasis was higher than that in patients without lymph node metastasis; and the expression of SIK2 in patients with schistosome eggs in cancer tissues was higher than that in patients with schistosome eggs in paracancerous tissues (allP<0.01).Conclusions:Lymph node metastasis is more likely to be occurred in colorectal cancer patients with schistosomiasis, especially in those with schistosome eggs in tumor tissues. The expression of SIK2 may be correlated with chronic schistosomiasis, egg distribution and lymphatic metastasis.