结直肠癌中的HER-2、EGFR和Ki-67的蛋白表达及其临床病理学意义

目的 探讨结直肠癌的生物标记物HER-2、EGFR和Ki-67蛋白的表达与临床病理特征之间的关系.方法 采用免疫组化的方法检测244例结直肠癌中HER-2、EGFR和Ki-67的蛋白表达情况,并分析这些指标与临床病理特征的相关性.结果 EGFR蛋白阳性表达率是31.5%,其中有淋巴结转移组阳性率显著高于无淋巴结转移组(36.4% vs.19.7%,P=0.011),有远处转移组阳性率显著高于无远处转移组(45% vs.28.9%,P=0.045);HER-2蛋白阳性表达率是50.8%,有淋巴结转移组阳性率显著高于无淋巴结转移组(54.9% vs.40.8%,P=0.046);Ki-67蛋白阳性表达率是89.7%,有淋巴结转移者比无淋巴结转移的阳性表达率明显增高(92.5% vs.83.1%,P=0.028),肿瘤大体类型中,隆起型、溃疡型和浸润型的阳性表达率分别为89.4%、92.5%和77.8%,其差异具有显著意义(P=0.03).HER-2阳性率在EGFR阳性组(67.5%)高于在EGFR阴性组(43.1%),HER-2和EGFR的蛋白表达呈正相关(r=0.227,P<0.001).结论 HER-2、EGFR和Ki-67的表达水平增高与结直肠癌患者转移增强和预后较差相关.

Expression of HER-2,EGFR and Ki-67 protein in colorectal carcinoma and its clinicopathological value

Objective To explore the expression of HER-2,EGFR,Ki-67 proteins and the relationship with clinicopathological features in patients with colorectal cancer(CRC).Methods Immunohistochemistry(SP method)was used to detect the expression of HER-2,EGFR and Ki-67 proteins in 244 cases of colorectal cancer.Correlation of the clinicopathological characteristics and the expression of gene proteins were analyzed.Results The positive expression rate of EGFR was 31.5%,positive rate of EGFR in group with lymphal node(LN)metastasis was significantly higher than that without LN metastasis(36.4% vs.19.7%,P=0.011),also significantly higher in group with distant metastasis than that without distant metastasis(45% vs.28.9%,P=0.045).The HER-2 positive rate was 50.8%,the positive rate in group with LN metastasis was significantly higher than that without LN metastasis(54.9% vs.40.8%,P=0.046).The positive expression rate of Ki-67 was 89.7%,the positive rate in group with lymphal node(LN)metastasis was significantly higher than that without LN metastasisthan(92.5% vs.83.1%,P=0.028).In term of tumor gross types,the Ki-67 was positive in 89.4% of elevated type,92.5% of ulcer type and 77.8% of infiltrative type,respectively,and the difference was significant.The expression rate of HER-2 in EGFR positive group(67.5%)was significantly higher than that in EGFR negative group(43.1%).The expression of EGFR and HER-2 was positively correlated(r=0.227,P<0.001).Conclusions The CRC with higher expression of HER-2,EGFR and/or Ki-67 is associated with enhanced metastasize and result in worse prognosis of the patients.