结直肠黏膜光镜下炎症表现及NF-κB、COX-2的表达与结直肠肿瘤发病的相关性研究

The Microscopic Presentation of the Mucosa Close to the Colorectal Tumors and the Relationship between Inflammatory Factors and the Oncogenesis of Colorectal Tumors

目的了解结直肠癌、腺瘤患者结直肠黏膜是否存在慢性炎症状态,并通过检测炎症因子NF-κB、COX-2的表达,了解炎症与结直肠肿瘤发病的关系。方法根据结肠镜检查及病理结果分三组:(1)结直肠癌组31例;(2)结直肠腺瘤组29例;(3)正常对照组18例。取肿瘤组织及距肿瘤5cm处正常黏膜,对照组取正常黏膜组织制作标本切片,显微镜下比较各组组织淋巴细胞浸润程度及腺体形态变化情况;采用免疫组化方法比较炎症因子NF-κB、COX-2的表达水平。结果(1)淋巴细胞浸润程度根据严重程度分为四级,1～4级在结直肠癌旁黏膜中分别占6.5%、29%、51.6%、12.9%,在腺瘤旁黏膜中分别为31%、41.3%、27.6%、0%,在正常黏膜中分别为66.7%、16.7%、16.7%、0%,癌旁黏膜、腺瘤旁黏膜淋巴细胞浸润程度均显著高于正常结肠黏膜(P<0.001,P<0.05)。(2)结直肠癌旁黏膜腺体变异率(61.3%)显著高于正常结肠黏膜组织(27.8%)(P<0.05),腺瘤旁黏膜腺体变异率(44.8%)与正常结肠黏膜无明显差异(P=0.37)。(3)依表达程度由(-)至(+++)四级计算,NF-κB的表达率在结直肠癌组织中分别为0%、22.6%、48.4%、39%,癌旁黏膜中为51.6%、45.2%、3.2%、0%,腺瘤中为13.8%、31%、48.3%、6.9%,腺瘤旁黏膜中为51.8%、44.8%、3.4%、0%,在正常黏膜中为22.2%、77.8%、0%、0%,结直肠癌及腺瘤组织NF-κB的表达水平分别高于病变旁黏膜及正常黏膜(P<0.001)。(4)COX-2的表达率按(-)至(+++)四级计算在结直肠癌组织中分别为12.9%、32.3%、45.2%、9.7%,癌旁黏膜中为22.6%、41.9%、35.5%、0%,腺瘤中为0%、27.6%、72.4%、0%,腺瘤旁黏膜中为24.1%、48.3%、27.6%、0%,在正常黏膜中为5.6%、94.4%、0%、0%,结直肠癌COX-2的表达水平显著高于癌旁黏膜(P<0.05)及正常黏膜(P<0.01),腺瘤组织COX-2的表达水平亦显著高于腺瘤旁黏膜及正常黏膜(P<0.001)。结论结直肠癌、腺瘤患者结直肠粘膜存在慢性炎症,表现为淋巴细胞浸润、腺体变异。NF-κB、COX-2在结直肠癌、腺瘤组织中表达水平较高。

Objective: To understand whether the chronic inflammatory state exist in the colorectal mucosa of patients with colorectal carcinomas and adenomas. To study the relationship between the inflammatory factors and the oncogenesis of colorectal tumors by searching the contribution of NF-κB and COX-2. Methods: The patients were divided into three groups:the patients with colorectal cancers, the patients with adenoma and the control group. Choose the tissue of the neoplasm, the mucosa close to the neoplasm and th...