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目的探讨Snail蛋白表达在大肠癌的发生发展中的作用及意义。方法用免疫组化方法检测145例大肠石蜡标本的Snail表达。病例包括大肠炎25例、腺瘤40例、腺癌40例、转移性腺癌40例。结果依大肠炎、腺瘤、腺癌、转移性腺癌的次序,Snail阳性表达率分别为16.0%、67.5%、75.0%、95.0%,其中大肠炎组分别与其他三组比较,差异有统计学意义(P<0.05或P<0.01);腺瘤组与腺癌组比较,差异无统计学意义(P>0.05);腺瘤组和腺癌组分别与转移性腺癌组比较,差异有高度统计学意义(P<0.01)。依Ⅰ、Ⅱ、Ⅲ、Ⅳ临床分期次序,Snail阳性表达率分别为50.0%、62.1%、93.1%、95.0%,经比较,差异有高度统计学意义(P<0.01)。直肠癌和结肠癌的Snail阳性表达率分别为100.0%和67.4%,经比较,差异有高度统计学意义(P<0.01)。Snail阳性表达与性别、年龄、浸润深度、分化程度等无关。Snail阳性表达从大肠炎中诊断腺瘤的敏感性为67.5%,特异性为84.0%;从腺瘤中诊断腺癌的敏感性为85.0%,特异性为32.5%。结论 Snail在大肠黏膜演变成腺瘤和腺癌、从未转移性腺癌演变成转移性腺癌、从早期癌到晚期癌中表达显著升高,提示Snail可以促进大肠肿瘤的发生发展。
Objective To investigate the role and significance of Snail protein expression in the development of colorectal cancer. Methods The expression of Snail in 145 cases of large intestine paraffin was detected by immunohistochemistry. The cases included 25 cases of colitis, 40 cases of adenoma, 40 cases of adenocarcinoma and 40 cases of metastatic adenocarcinoma. Results According to the sequence of colitis, adenoma, adenocarcinoma and metastatic adenocarcinoma, the positive rates of Snail were 16.0%, 67.5%, 75.0% and 95.0% respectively. The difference between the colitis group and the other three groups was statistically significant (P <0.05 or P <0.01). There was no significant difference between adenoma group and adenocarcinoma group (P> 0.05). There was a high degree of difference between adenoma group and adenocarcinoma group and metastatic adenocarcinoma group Significance (P <0.01). According to the clinical staging of Ⅰ, Ⅱ, Ⅲ, Ⅳ, the positive rates of Snail were 50.0%, 62.1%, 93.1% and 95.0% respectively. There was a statistically significant difference between the two groups (P <0.01). The positive rates of Snail in rectal cancer and colon cancer were 100.0% and 67.4%, respectively, and the difference was highly significant (P <0.01). The positive expression of Snail has nothing to do with gender, age, depth of invasion, degree of differentiation and so on. The positive rate of Snail in adenomas was 67.5% and the specificity was 84.0%. The sensitivity and specificity of Snail in diagnosing adenocarcinoma were 85.0% and 32.5% respectively. Conclusion Snail evolved into adenoma and adenocarcinoma in the mucosa of the colon. The metastasis of adenocarcinoma never progressed to metastatic adenocarcinoma. The expression of Snail was significantly increased from early carcinoma to late carcinoma, suggesting that Snail can promote the development of colorectal tumors.