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目的:研究金属支架治疗的晚期直肠癌组织中细胞黏附分子唾液酸化Lewis X的表达及反应强度与肿瘤侵袭、转移及患者预后的关系。 方法:应用免疫组织化学催化信号放大法(CSA)和计算机图像分析技术,对30例支架治疗的晚期直肠癌患者活检标本进行唾液酸化Lewis X表达和反应强度定量检测。 结果:30例支架治疗的晚期直肠癌组织中共28例呈唾液酸化Lewis X阳性表达,阳性率高达93.3％。阳性物质主要分布于癌组织腺管细胞膜、细胞浆和黏液腺癌的黏液糊内。图像分析显示,唾液酸化Lewis X阳性细胞平均积分光密度值在低分化腺癌中显著高于高、中分化腺癌和黏液腺癌(P<0.01),有淋巴结转移者显著高于无淋巴结转移者(P<0.01),1a内死亡病例显著高于生存病例(P<0.01)。 结论:唾液酸化Lewis X表达阳性率和反应强度与晚期直肠癌侵袭程度、淋巴结转移状况和患者生存期密切相关,对于判断其恶性程度、预测生物学行为和评估支架置入后患者的预后具有重要临床意义。
OBJECTIVE: To investigate the expression of sialyl Lewis X and its relationship with tumor invasion, metastasis and prognosis in advanced colorectal cancer patients treated with metal stent. Methods: The immunohistochemical catalysis signal amplification (CSA) and computer image analysis were used to quantitatively detect the expression of sialyl Lewis X and the reaction intensity in 30 patients with advanced rectal cancer treated with stents. Results: Twenty-eight cases of advanced colorectal carcinoma treated with stents were positive for sialyl Lewis X, the positive rate was 93.3%. Positive substances are mainly distributed in the cancer cell membrane, cell mucus and mucinous adenocarcinoma mucus paste. Image analysis showed that the mean integrated optical density of sialyl Lewis X-positive cells was significantly higher in poorly differentiated adenocarcinomas than in high and moderately differentiated adenocarcinomas and mucinous adenocarcinomas (P <0.01), and those with lymph node metastases were significantly higher than those without lymph node metastases (P <0.01), and the deaths in 1a were significantly higher than those in survival (P <0.01). CONCLUSIONS: The positive rate and intensity of sialyl Lewis X expression are closely related to the invasion of advanced rectal cancer, the status of lymph node metastasis and the survival of patients. It is important to judge the degree of malignancy, predict the biological behavior and evaluate the prognosis of patients after stent implantation Clinical significance.