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目的研究CD44和埃兹(Ezrin)蛋白在散发性结、直肠癌转移组及未转移组中的表达、相互关系及临床意义。方法应用EnVision免疫组化法检测132例散发性结、直肠癌(转移组74例、未转移组58例)中CD44和埃兹蛋白的表达,将二者分别与患者的临床病理参数进行统计分析并评估二者的相关性,同时进行单因素和多因素生存分析。结果CD44在转移组中的阳性率(71.6%)高于未转移组(53.4%,P=0.031)。埃兹蛋白在转移组中的阳性率(86.5%)亦高于未转移组(70.7%,P=0.026)。CD44和埃兹蛋白共表达率转移组(63.5%)高于未转移组(43.1%,P=0.019)。二者在结、直肠癌中的表达呈正相关(P=0.020,r=0.202)。二者均与患者年龄、性别、肿瘤大小、部位、分化程度、浸润深度等临床病理参数无关(P>0.05)。单因素生存分析显示,CD44阳性、埃兹蛋白阳性及二者共表达均与患者的无病生存率相关(P<0.05)。多因素生存分析显示,CD44、埃兹蛋白共表达是结、直肠癌独立的预后影响因子(P<0.05)。结论CD44和埃兹蛋白的表达与结、直肠癌转移密切相关,在结、直肠癌发生发展过程中起协同作用,二者均为阳性表达的患者无病生存率低于阴性表达者,CD44和埃兹蛋白共表达对于评估散发性结、直肠癌的预后有一定的价值。
Objective To study the expression, correlation and clinical significance of CD44 and Ezrin in sporadic and rectal cancer patients with metastasis and non-metastasis. Methods EnVision immunohistochemical method was used to detect the expression of CD44 and Ezrin in 132 cases of sporadic colorectal cancer (74 cases of metastasis and 58 cases of non-metastasis), and their clinical pathological parameters were analyzed respectively And assess the correlation between the two, while single factor and multivariate survival analysis. Results The positive rate of CD44 in metastasis group (71.6%) was higher than that in non-metastasis group (53.4%, P = 0.031). The positive rate of Ezrin in the metastasis group (86.5%) was also higher than that in the non-metastasis group (70.7%, P = 0.026). The rate of CD44 and Ezrin co-expression in metastasis group (63.5%) was higher than that in non-metastasis group (43.1%, P = 0.019). There was a positive correlation between the two in colorectal cancer (P = 0.020, r = 0.202). Both of them were not related to clinicopathological parameters such as patient’s age, gender, tumor size, location, degree of differentiation and depth of invasion (P> 0.05). Univariate survival analysis showed that the positive of CD44, the positive of Ezrin and the co-expression of both were correlated with the disease-free survival rate (P <0.05). Multivariate survival analysis showed that co-expression of CD44 and ezrin was an independent predictor of prognosis in colorectal cancer (P <0.05). Conclusions The expression of CD44 and Ezrin is closely related to the metastasis of colorectal cancer and plays a synergistic role in the development and progression of colorectal cancer. The patients with positive expression of CD44 and ezrin have lower disease-free survival rate than those with negative expression. CD44 and CD44 Ez protein co-expression for the assessment of sporadic, rectal cancer prognosis of a certain value.