CD44s表达与结直肠癌病理分期及预后的关系

目的 探讨标准型CD44(CD44s)在结直肠癌及癌旁黏膜中表达的临床应用价值.方法 对74例结直肠癌及癌旁黏膜进行免疫组织化学检测,应用Log-rank检验和COX比例风险模型分析CD44s表达与患者预后的关系.结果 CD44s在结直肠癌及癌旁黏膜巾表达的阳性率分别为42%、16%.按TNM系统肿瘤分期,Ⅲ～Ⅳ期结直肠癌CD44s强阳性染色为39%,显著高于Ⅰ～Ⅱ期的6%(X2=8.46,P＜0.01).全组中位随访时间58个月,CD44s表达阳性与阴性患者术后生存率比较差异有统计学意义(x~2=17.82,P＜0.01).在Ⅲ～Ⅳ期结直肠癌患者中,CD44s表达阳性者的术后总生存期显著短于CD44s表达阴性者(x~2=16.23,P＜0.01);而在Ⅰ～Ⅱ期结直肠癌患者中,CD44s表达阳性和阴性者的预后相比差异无统计学意义(x~2=1.34,P＞0.05).COX多因素分析表明,TNM分期和CD44s表达是反映结直肠癌预后的独立指标. 结论 CD44s过表达与结直肠癌病期进展和预后相关.

CD44s expression study in colorectal cancer tissues

Objective To investigate the relationship between standard CD44(CD44s)expression and tumor stage and prognosis in colorectal cancer.Methods CD44s expression was detected by immunohistochemistry in tumor tissues and normal mucosa specimens from 74 cases of primary colorectal cancer.Results Of 74 cases,the expression of CD44s in colorectal cancer tissue and normal mucosa specimens was documented in 42% and 16%,respectively.The expression of CD44s in primary tumors significantly increased in stage Ⅲ and Ⅳ than in stage Ⅰ and Ⅱ(39% vs.6%,x~2=8.46,P＜0.01).A statistically significant correlation was observed between the overall survival and CD44s expression(x~2=17.82,P＜0.01).Furthermore,a poor prognosis of CD44s-positive tumors was observed in patients with stage Ⅲ and Ⅳ colorectal cancer(x~2=16.23,P＜0.01),but not in patients with stage Ⅰ and Ⅱ colorectal cancer(x~2=1.34,P＞0.05).Multivariate analysis indicated that TNM stage and CD44s expression were independent predictors of overall survival in colorectal cancer.Conclusion CD44s overexpression is involved in the progress of colorectal cancer and predicting the prognosis.