nm23-H_1与大肠癌微转移关系的研究

Expression of nm23-H_1 protein in human colorectal carcinoma

目的探讨nm23-H1基因表达与大肠癌浸润、微转移和预后的关系。方法经病理确诊的120例大肠癌组织标本,采用SP法检测nm23-H1基因蛋白表达、巢式RT-PCR方法检测进入外周静脉血的大肠癌微转移灶(CK20mRNA),并与同一患者大肠癌组织标本中nm23-H1基因表达情况进行综合分析。结果nm23-H1在大肠癌中的阳性表达率为61.7%(74/120),低分化腺癌中nm23-H1阳性表达率(41.0%)显著低于高中分化腺癌中的表达率(70.3%)(P<0.05);有淋巴结转移者nm23-H1阳性表达率为53.7%,无淋巴结转移者为71.7%,两组比较有显著性差异(P<0.05);120例大肠癌患者术后3年随访中,CK20mRNA阳性检出率为41.5%,nm23-H1阳性表达率与CK2OmRNA阳性率呈显著负相关(P<0.001);nm23-H1蛋白阳性表达组术后3年生存率为60.8%(45/74),阴性表达组术后3年生存率为21.7%(10/46),二组比较有显著性差异(P<0.001)。结论nm23-H1与大肠癌细胞分化、淋巴结转移及外周静脉血中微转移密切相关,是影响大肠癌预后的重要指标之一。

Objective： To study the relationship between nm23 - H1 gene express and cancer of colon in infihration,metastasis and prognosis. Methods： Total of 120 patients histiospecimen after operation with cancer of colon were detected by SP to study nm23 - H1 gene expression. Thesel20 patients with cancer of colon were regularly followed up over 3 years after operation , meanwhile detected cancer of colon micrometastasis（CK20mRNA） in peripheral venous blood by nested RT - PCR method. Aggregate analysis was made in the same case about the relationship between nm23 - H1 gene express with cancer of colon micrometastasis. Results： Nm23 - H1 gene positive expression rate was 61.7% （74/120） in 120 patients with cancer of colon;nm23 - H1 express rate（41.0% ）in poorly differentiated adenocarcinoma was more less than nm23 - H1 express rate（70.3% ） in high or middle differentiated adenocarcinoma（ P 〈 0.05 ） ; nm23 - H1 positive expressing rate with globate glands metastasis was 53.7%, nm23 - H1 positive expression rate with non -globate glands metastasis was 71.7%, there was a significant difference （P 〈 0.05 ）between these groups;in the course of follow - up over 3 years after operation,51 out of 120 cases with rectal cancer , rectal cancer CK20mRNA in peripheral venous blood were positive express. The positive express rate was 41.5% （51/ 120）. There was a notable negative correlation between the nm23 - H1 negative express in rectal cancer histio - specimen with the positive express of CK20mRNA after operation （ P 〈 0. 001 ） ; the 3 - year survival rate in nm23 - H1 positive express group was 60.8% （45/74） ,21.7% in negative express group, there wse a notable difference betwecn these two groups. Conclusion： The nm23 -H1 protein expression level of protein may be associated with the development and poor prognosis of cancer of colon . It is very significant detecting nm23 - H1 gene express to guide combined therapy after operation.