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目的探讨人直肠癌和相应癌旁正常直肠黏膜组织中肿瘤相关基因的表达及其临床意义。方法取54例直肠癌、40例癌旁直肠黏膜组织制成54点和130点两块组织芯片,采用免疫组织化学法检测直肠组织芯片中p53、cyclin D1、bcl-2、β-catenin、c-myc、COX-2以及nm23-h1的表达。结果p53、cy-clin D1、bcl-2、β-catenin、c-myc、COX-2以及nm23-h1在直肠癌和正常直肠黏膜组织中的表达差异有统计学意义(P<0.05),其中p53与bcl-2表达之间呈正相关(r=0.332,P=0.001),β-catenin与c-myc的表达呈正相关(r=0.447,P=0.000)。在直肠癌组织中,β-catenin与年龄有关,>60岁患者中β-catenin表达率高于<60岁患者(P=0.032)。β-catenin和bcl-2虽与组织学有关,但却表现为分化程度高组织表达率高(P=0.001,P=0.006)。cyclin D1的表达与临床分期有关(P=0.039),与其他病理资料无关。nm23-h1的表达与组织分化程度、远处转移以及Duke分期有关(P=0.003,P=0.022,P=0.002),与其他临床病理资料无关。p53、c-myc、COX-2的表达与临床病理资料无关。结论p53、cyclin D1、bcl-2、β-catenin、c-myc、COX-2以及nm23-h1的异常表达与直肠癌的发生可能有关,尤其是p53、cyclin D1、bcl-2的高表达可能有助于直肠癌的早期诊断。cyclinD1的表达可能还参与了直肠癌的临床进展,nm23-h1与肿瘤的转移相关,该基因的低表达预示肿瘤的较强侵袭潜能。
Objective To investigate the expression of tumor-associated genes in human rectal cancer and its corresponding adjacent normal mucosa and its clinical significance. Methods 54 cases of rectal cancer and 40 cases of paracancer rectal mucosa were used to make 54 and 130 tissue microarrays. The expressions of p53, cyclin D1, bcl-2 and β-catenin in rectal tissue were detected by immunohistochemistry -myc, COX-2 and nm23-h1 expression. Results The expressions of p53, cy-clin D1, bcl-2, β-catenin, c-myc, COX-2 and nm23-h1 were significantly different between rectal cancer and normal rectal mucosa (P <0.05) There was a positive correlation between the expression of p53 and bcl-2 (r = 0.332, P = 0.001) and the expression of c-myc (r = 0.447, P = 0.000). In rectal cancers, β-catenin is age-related, with a higher prevalence of β-catenin in patients> 60 years than in patients <60 years (P = 0.032). Although β-catenin and bcl-2 are histologically related, they show high histological grade (P = 0.001, P = 0.006). The expression of cyclin D1 was correlated with clinical stage (P = 0.039), but not with other pathological data. The expression of nm23-h1 was correlated with the degree of differentiation, distant metastasis and Dukes stage (P = 0.003, P = 0.022, P = 0.002), but not with other clinicopathological data. The expression of p53, c-myc, COX-2 was not related to clinicopathological data. Conclusions The abnormal expression of p53, cyclin D1, bcl-2, β-catenin, c-myc, COX-2 and nm23-h1 may be related to the occurrence of rectal cancer, especially the high expression of p53, cyclin D1 and bcl- Helps to diagnose early rectal cancer. The expression of cyclinD1 may be involved in the clinical progress of rectal cancer. The expression of nm23-h1 is correlated with tumor metastasis. The low expression of cyclinD1 indicates the strong invasion potential of tumor.