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目的探讨梗阻性结直肠癌中E-cadherin(E-cad)、CD44v6的表达及与预后的关系。方法采用免疫组织化学方法分别检测48例梗阻性结直肠癌、121例非梗阻性结直肠癌组织和30例癌旁肠黏膜组织中E-cad和CD44v6蛋白的表达,Kaplan-Meier法绘制生存曲线,Cox比例风险模型多因素分析。结果梗阻性结直肠癌组织中E-cad和CD44v6的标准化阳性率分别为30.2%和81.3%,非梗阻性结直肠癌组织中E-cad和CD44v6的标准化阳性率分别为51.8%和58.9%,两组差异有统计学意义(P<0.05)。E-cad的表达与肿瘤p TNM分期、淋巴结转移、分化程度、浸润深度有关(P<0.05)。CD44v6表达与肿瘤p TNM分期和淋巴结转移有关(P<0.05)。单因素生存分析显示:梗阻、E-cad和CD44v6表达是影响预后的危险因素。Cox回归模型显示:E-cad的表达、淋巴结转移、分化程度为影响结直肠癌患者预后的独立危险因素。结论 E-cad表达下降和CD44v6表达升高与梗阻性结直肠癌较差的预后密切相关。
Objective To investigate the expression of E-cadherin (CD44v6) and prognosis in patients with obstructive colorectal cancer. Methods The expressions of E-cad and CD44v6 in 48 cases of obstructive colorectal cancer, 121 cases of non-obstructive colorectal cancer and 30 cases of para-cancerous intestinal mucosa were detected by immunohistochemistry. The survival curves were drawn by Kaplan-Meier method , Cox proportional hazards model multivariate analysis. Results The normalized positive rates of E-cad and CD44v6 in obstructive colorectal cancer were 30.2% and 81.3% respectively. The normalized positive rates of E-cad and CD44v6 in non-obstructive colorectal cancer tissues were 51.8% and 58.9%, respectively. The difference between the two groups was statistically significant (P <0.05). The expression of E-cad was correlated with the p TNM stage, lymph node metastasis, differentiation and depth of invasion (P <0.05). The expression of CD44v6 was associated with TNM stage and lymph node metastasis (P <0.05). Univariate survival analysis showed that obstruction, E-cad and CD44v6 expression were the risk factors influencing prognosis. Cox regression model showed that E-cad expression, lymph node metastasis and differentiation were the independent risk factors affecting the prognosis of patients with colorectal cancer. Conclusions The decrease of E-cad expression and the increase of CD44v6 expression are closely related to the poor prognosis of obstructive colorectal cancer.