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目的探讨肝素酶(heparinase)和碱性成纤维细胞生长因子(bFGF)在大肠癌组织中表达的临床意义及大肠转移和预后的关系。方法采用免疫组织化学、原位杂交方法,检测115例大肠癌石蜡切片和45例正常大肠黏膜中肝素酶和bFGF的表达情况。采用χ2检验、t检验、生存曲线和Cox比例风险回归等方法分析肝素酶和bFGF分别表达及共表达的意义。结果免疫组织化学染色证实肝素酶(91/115)和bFGF(89/115)主要表达在肿瘤细胞细胞质和(或)细胞膜中,在正常大肠黏膜上皮则呈阴性表达。肝素酶在大肠癌肿瘤细胞中表达明显增高(P=0.0001),统计结果显示肝素酶和bFGF的表达具有明显的一致性(P=0.0001),两者单独表达和共表达均与大肠癌的分期、血管浸润、淋巴结转移、微血管密度和预后有关。其中,两者共表达时与分期和微血管密度的相关性更显著;另外,bFGF还与大肠癌的分化程度有关。多因素分析结果显示大肠癌的分化程度、血管浸润、淋巴结转移和bFGF表达可以作为判断大肠癌预后的危险因素,但肝素酶不是影响预后的独立因素。结论肝素酶和bFGF均与大肠癌的转移、血管生成和预后密切相关。
Objective To investigate the clinical significance of heparinase and basic fibroblast growth factor (bFGF) expression in colorectal carcinoma and the relationship between metastasis and prognosis. Methods Immunohistochemistry and in situ hybridization were used to detect the expression of heparanase and bFGF in 115 cases of colorectal cancer paraffin sections and 45 cases of normal colorectal mucosa. The significance of expression and co-expression of heparanase and bFGF was analyzed by χ2 test, t test, survival curve and Cox proportional hazards regression analysis. Results Immunohistochemical staining confirmed that heparanase (91/115) and bFGF (89/115) were mainly expressed in cytoplasm and / or cell membrane of tumor cells, but negative in normal colorectal epithelium. The expression of heparanase in colorectal cancer cells was significantly higher (P = 0.0001). The statistical results showed that the expression of heparanase and bFGF was significantly consistent (P = 0.0001). Both expression and co-expression of heparanase and colorectal cancer Staging, vascular invasion, lymph node metastasis, microvessel density and prognosis. Among them, the co-expression of the two with staging and microvessel density more significant correlation; In addition, bFGF also with the degree of differentiation of colorectal cancer. Multivariate analysis showed that the degree of differentiation of colorectal cancer, vascular invasion, lymph node metastasis and bFGF expression can be used as a risk factor to determine the prognosis of colorectal cancer, but heparanase is not an independent prognostic factor. Conclusion Both heparanase and bFGF are closely related to the metastasis, angiogenesis and prognosis of colorectal cancer.