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目的:观察19号染色体开放阅读框5（C19ORF5）调节自噬活性与结直肠癌恶性程度和紫杉醇化疗敏感性的关系。方法:选取哈尔滨医科大学附属第二医院2015—2017年141例结直肠癌患者的肿瘤组织和癌旁正常组织，采用免疫组织化学法和实时定量聚合酶链反应法检测C19ORF5蛋白和mRNA的表达情况，探讨C19ORF5蛋白调节自噬活性与结直肠癌恶性程度的相关性。141例患者均行术后化疗，91例采用常规化疗方案（卡培他滨联合奥沙利铂，常规化疗组），50例采用常规方案联合紫杉醇化疗（紫杉醇组），两组均治疗6个疗程。结果:癌组织在透射电镜下可见自噬体，C19ORF5蛋白为淡黄色至棕褐色颗粒，表达于细胞质；癌组织C19ORF5蛋白染色强度明显强于正常组织，且Ⅱ期染色强度明显高于Ⅳ期。Ⅰ~Ⅱ期患者C19ORF5蛋白高表达率明显高于Ⅲ~Ⅳ期患者[83.3%（25/30）比17.1%（19/111）]，差异有统计学意义（n P0.05）。在常规化疗组中，有效患者和无效患者化疗前癌组织与化疗后血清C19ORF5蛋白表达水平比较差异均无统计学意义（n P>0.05）；有效患者与无效患者化疗后血清C19ORF5蛋白表达水平比较差异无统计学意义（n P>0.05）。在紫杉醇组中，有效患者化疗前癌组织C19ORF5蛋白表达水平明显高于化疗后血清C19ORF5蛋白表达水平（0.9 ± 0.3比0.5 ± 0.2），有效患者化疗后血清C19ORF5蛋白表达水平明显低于无效患者（0.5 ± 0.2比0.8 ± 0.2），差异有统计学意义（n P0.05). In conventional chemotherapy group, there was no significant difference in serum C19ORF5 protein expression levels between cancer tissues before and after chemotherapy in effective patients and ineffective patients (n P>0.05); there was no significant difference in serum C19ORF5 protein expression levels between effective patients and ineffective patients after chemotherapy (n P>0.05). In paclitaxel group, the expression level of C19ORF5 protein in cancer tissues before chemotherapy was significantly higher than that in serum C19ORF5 protein after chemotherapy: 0.9 ± 0.3 vs. 0.5 ± 0.2, the expression level of serum C19ORF5 protein in patients with effective chemotherapy was significantly lower than that in ineffective patients: 0.5 ± 0.2 vs. 0.8 ± 0.2, and there were statistical differences (n P<0.05).n Conclusions:The high expression of C19ORF5 protein can increase the autophagy activity of colorectal cancer tissue; C19ORF5 protein regulates autophagy activity and is negatively correlated with the malignant degree of colorectal cancer; C19ORF5 protein may increase the sensitivity of paclitaxel chemotherapy by enhancing autophagy activity.