CD44v6和Ezrin与大肠腺瘤癌变及预后的关系

目的： 探讨CD44v6和Ezrin在大肠腺瘤癌变中的表达及其与临床病理指标和预后的关系。方法：应用免疫组化检测CD44v6和Ezrin蛋白在大肠腺癌(80例)、腺瘤伴低级别上皮内瘤变(40例)、腺瘤伴高级别上皮内瘤变(20例)及正常黏膜(20例)中的表达，分析其表达与临床病理指标及生存时间的关系。结果：CD44v6和Ezrin在腺瘤伴高级别上皮内瘤变和腺癌组的表达高于正常黏膜及腺瘤伴低级别上皮内瘤变组，差别有统计学意义(P均<0.05)。二者在淋巴结有转移组、有浆膜层浸润组、III~IV期的表达分别高于淋巴结无转移组、无浆膜层浸润组及I~II期，差别均有统计学意义(P均<0.05)。CD44v6和Ezrin表达与患者生存时间相关(Log-rank= 18.587，P<0.05；Log-rank=7.804，P<0.05)。Cox回归多因素分析显示CD44v6是独立的预后危险因素(HR：7.582，95% CI： 1.605~ 35.815，P=0.011)。结论：CD44v6和Ezrin的表达与大肠腺瘤癌变、浸润和转移相关，联合检测CD44v6和Ezrin的表达对判断大肠腺瘤癌变及预后具有参考价值。

The expressions of CD44v6 and Ezrin are correlated with colorectal adenoma carcinogenesis and prognosis

OBJECTIVE:We explored the expressionsofCD44v6 andEzrin in colorectal adenoma carcinogenesis and their correlations with clinicopathological factors and prognosis. METHODS:Immunohistochemistry for CD44v6 and Ezrin were performed in normal mucosa(20 cases),low grade adenoma tissues(40 cases) ,high grades adenoma tissues(20 cases)and colorectal cancer(80 cases). The correlations between expressions of CD44v6 and Ezrin with survival time and clinicopathological factors were evaluated.RESULTS:Expressions of CD44v6 and Ezrin in high grades colorectal adenomas and adenocarcinoma groups were higher than normal mucosa and low grade colorectal adenoma groups(P<0.01). Expressions were higher in lymph node metastasis group,serosal infiltration group,stages III-IV group than no lymph node metastasis group,no serosal infiltration and stages I-II group. CD44v6 and Ezrin were significantly correlated with survival time(Log-rank=18.587,P<0.05;Log-rank=7.804,P<0.05). Cox regression analysis showed that CD44v6 was an independent risk factor for prognosis (HR:7.582,95%CI:1.605-35.815,P=0.011).CONCLUSION:The expressions of CD44v6 and Ezrin were correlated with process of colorectal adenoma-carcinoma transition,invasion and metastasis. It would be valuable to c ombine C D44v6 a nd E zrin t o p redict m alignant t ransformation o f c olorectal a denoma a nd p rognosis.