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目的:探讨CD44v6和Ezrin在大肠腺瘤癌变中的表达及其与临床病理指标和预后的关系。方法:应用免疫组化检测CD44v6和Ezrin蛋白在大肠腺癌(80例)、腺瘤伴低级别上皮内瘤变(40例)、腺瘤伴高级别上皮内瘤变(20例)及正常黏膜(20例)中的表达,分析其表达与临床病理指标及生存时间的关系。结果:CD44v6和Ezrin在腺瘤伴高级别上皮内瘤变和腺癌组的表达高于正常黏膜及腺瘤伴低级别上皮内瘤变组,差别有统计学意义(P均<0.05)。二者在淋巴结有转移组、有浆膜层浸润组、III~IV期的表达分别高于淋巴结无转移组、无浆膜层浸润组及I~II期,差别均有统计学意义(P均<0.05)。CD44v6和Ezrin表达与患者生存时间相关(Logrank=18.587,P<0.05;Log-rank=7.804,P<0.05)。Cox回归多因素分析显示CD44v6是独立的预后危险因素(HR:7.582,95%CI:1.605~35.815,P=0.011)。结论:CD44v6和Ezrin的表达与大肠腺瘤癌变、浸润和转移相关,联合检测CD44v6和Ezrin的表达对判断大肠腺瘤癌变及预后具有参考价值。
Objective: To investigate the expression of CD44v6 and Ezrin in colorectal adenoma and its relationship with clinicopathological parameters and prognosis. Methods: The expressions of CD44v6 and Ezrin in colorectal adenocarcinoma (80 cases), adenoma with low grade intraepithelial neoplasia (40 cases), adenoma with high grade intraepithelial neoplasia (20 cases) and normal mucosa (20 cases). The relationship between the expression and clinicopathological parameters and survival time was analyzed. Results: The expressions of CD44v6 and Ezrin in adenoma with high grade intraepithelial neoplasia and adenocarcinoma were significantly higher than those in normal mucosa and adenoma with low grade intraepithelial neoplasia (P <0.05). The two groups had lymph node metastasis, serosal invasion group, the expression of stage III-IV was higher than lymph node-free metastasis group, serosa-free layer invasion group and stage I-II, the differences were statistically significant (P <0.05). CD44v6 and Ezrin expression correlated with patient survival time (Logrank = 18.587, P <0.05; Log-rank = 7.804, P <0.05). Cox regression multivariate analysis showed that CD44v6 was an independent prognostic risk factor (HR: 7.582, 95% CI: 1.605-35.815, P = 0.011). Conclusion: The expressions of CD44v6 and Ezrin correlate with the carcinogenesis, invasion and metastasis of colorectal adenomas. The combined detection of CD44v6 and Ezrin may be valuable in judging the carcinogenesis and prognosis of colorectal adenomas.