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目的检测原发性结直肠癌患者术中腹腔灌洗液悬浮细胞中的CDH1基因启动子所在5’-Cp G岛的异常甲基化,同时对其异常甲基化与临床病情发展、病理变化及术后预后的相关关系进行探讨。方法选取该院肿瘤科进行结直肠癌切除术的原发性结直肠癌患者,所有入选患者由专人进行跟踪随访。检测CDH1基因启动子所在5’-Cp G岛的异常甲基化,对其异常甲基化与临床病情发展、病理变化及术后预后的相关关系进行探讨。结果该研究共纳入患者184例,其中甲基化组86例,非甲基化组98例。对两组患者临床病理结果检查可知甲基化组肿瘤直径大于非甲基化组(P<0.001),甲基化组肿瘤浸润性所占比例高于非甲基化组(P<0.001),甲基化组肿瘤分化程度低于非甲基化组(P<0.001),甲基化组淋巴转移率、远处转移率高于非甲基化组(P<0.001,P=0.026),甲基化组临床TNM分期更晚(P<0.001)。根据随访结果显示非甲基化组患者生存率高于甲基化组患者(P<0.05)。Cox比例风险模型结果显示,患者肿瘤的大体分型、分化程度、侵袭程度和病理分期是影响生存预后的变量,其中腹腔灌洗液悬浮细胞CDH1基因甲基化是影响预后最重要的独立因素,RR=28.514。结论原发性结直肠癌患者腹腔灌洗液悬浮细胞CDH1基因甲基化程度提高,恶性程度高,预后差。
Objective To detect the abnormal methylation of 5’-Cp G island where CDH1 gene promoter resides in intraperitoneal lavage fluid in patients with primary colorectal cancer. Meanwhile, its abnormal methylation, clinical progression and pathological changes And postoperative prognosis of the relationship between the discussion. Methods Patients with primary colorectal cancer who underwent resection of colorectal cancer in the hospital were enrolled. All selected patients were followed up by hand. Detecting the abnormal methylation of 5’-Cp G island where CDH1 gene promoter is located, and discussing the relationship between abnormal methylation and clinicopathological changes, pathological changes and postoperative prognosis. Results A total of 184 patients were enrolled in this study, including 86 methylated patients and 98 non-methylated patients. The clinicopathological findings of the two groups showed that the methylation group had a larger tumor diameter than the non-methylated group (P <0.001), and the methylation group had a higher proportion of tumor infiltration than the non-methylated group (P <0.001) Methylation group had lower degree of tumor differentiation than non-methylation group (P <0.001), methylation group, lymph node metastasis rate and distant metastasis rate were higher than those in non-methylation group (P <0.001, P = 0.026) The clinical stage of TNM staging was later (P <0.001). The follow-up results showed that the survival rate of non-methylated group was higher than that of methylated group (P <0.05). Cox proportional hazards model results showed that the general classification of tumor, the degree of differentiation, the degree of invasion and the pathological stage were the variables that affect the prognosis of survival. The methylation of CDH1 gene in the peritoneal lavage fluid suspension cells was the most important independent factor affecting the prognosis, RR = 28.514. Conclusions CDH1 gene methylation is higher in patients with primary colorectal cancer than in patients with peritoneal lavage fluid. The degree of malignancy is high and the prognosis is poor.