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目的:探讨血吸虫病性大肠息肉是否为癌前病变,从而为内镜下息肉切除适应证提供依据。方法:收集70例血吸虫病性大肠息肉及相应患者正常肠黏膜组织,68例结直肠癌组织,采用实时定量PCR检测CK-20、Bcl-2、p27基因的表达,并通过TUNEL法检测相应组织的细胞凋亡。结果:腺瘤性血吸虫病性大肠息肉中,癌基因Bcl-2、CK-20mRNA表达较非腺瘤性血吸虫病性大肠息肉和正常肠黏膜组织均有不同程度上调(P<0.001),抑癌基因p27表达明显下调(P<0.001);腺瘤性血吸虫病性大肠息肉中CK-20、p27表达较结直肠癌组织无明显差异(P>0.05)。TUNEL法检测细胞凋亡结果发现,非腺瘤性血吸虫病性息肉组织凋亡率明显低于结直肠癌组织,差异有显著性(P=0.032);腺瘤性大肠息肉凋亡率低于大肠癌组织,但无统计学差异(P=0.315)。结论:腺瘤性血吸虫病性大肠息肉为癌前病变,非腺瘤性息肉为炎性增生性病变,在行内镜下息肉切除时应注意甄别,避免过度治疗。
Objective: To investigate whether schistosomiasis colorectal polyps is a precancerous lesion, so as to provide a basis for endoscopic polypectomy indications. Methods: 70 cases of schistosomiasis colorectal polyps and corresponding normal intestinal mucosa and 68 cases of colorectal cancer tissues were collected. The expression of CK-20, Bcl-2 and p27 genes were detected by real-time quantitative PCR and the corresponding tissues were detected by TUNEL method Apoptosis. Results: The expression of oncogenes Bcl-2 and CK-20 mRNA in colorectal polyps of adenomatous schistosomiasis was up-regulated to some extent (P <0.001) and tumor suppressor than non-adenomatous schistosomiasis colorectal polyps and normal mucosa The expression of p27 gene was significantly down-regulated (P <0.001). The expression of CK-20 and p27 in colorectal polyps of adenomatous schistosomiasis was not significantly different from that of colorectal carcinoma (P> 0.05). TUNEL assay showed that the apoptosis rate of non-adenomatous schistosomiasis polyp tissues was significantly lower than that of colorectal cancer tissues (P = 0.032). The apoptosis rate of adenomatous polyps was lower than that of the large intestine Cancer tissue, but no significant difference (P = 0.315). Conclusion: Adenomatous schistosomiasis of colorectal polyps is a precancerous lesion and non-adenomatous polyps are inflammatory hyperplastic lesions. During endoscopic polypectomy, precaution should be taken to avoid over-treatment.