Dukes' A、B期结直肠癌c-erbB-2,EGFR和TGF-α表达与复发转移的关系

Correlations of c-erb-B2,EGFR,and TGF-α Expression to Recurrence of Dukes' A and B Colorectal Carcinoma

背景与目的:尽管病理分期是结直肠癌患者主要的预后指标,但目前的分期系统不足以预测Dukes' A、B期患者术后复发风险及指导辅助治疗。分子预后标志物有可能补充分期的不足,且能为基于肿瘤个体生物学特征的治疗决策提供依据。本研究旨在探讨Dukes' A、B期结直肠癌中c-erbB-2、表皮生长因子受体(epithelial growth factor receptor,EGFR)、转化生长因子α(transforming growth factor-α,TGF-α)表达与术后复发转移的关系。方法:收集中山大学肿瘤防治中心1989年～1999年间88例行根治性手术的结直肠腺癌病例,Dukes' A期26例,Dukes' B期62例,复发转移组和非复发转移组各44例。至少随访5年或随访至复发。应用免疫组化方法检测原发瘤组织中c-erbB-2、EGFR、TGF-α蛋白表达。结果:复发组c-erbB-2、EGFR、TGF-α过表达率分别为43.2%(19/44)、63.6%(28/44)、65.9%(29/44),非复发组阳性率分别为25.0%(11/44)、27.3%(12/44)、43.2%(19/44)。χ2检验提示复发组EGFR、TGF-α过表达率明显高于非复发组,但两组c-erbB-2过表达率无差异。复发组EGFR和TGF-α共同过表达率36.4%(16/44)显著高于非复发组11.4%(5/44)(χ2=7.568,P=0.006)。多因素分析显示EGFR表达与术后复发转移有关。结论:EGFR表达可能与Dukes’A、B期结直肠癌术后复发转移有关。

BACKGROUND ＆ OBJECTIVE： Currently, pathologic stage is the main prognostic indicator of colorectal carcinoma, but the current staging system is insufficient to predict the risk of recurrence or the need for adjuvant treatment for the patients with Dukes＇ A and B disease. Biologic prognostic markers may supplement the staging system and provide a basis for the decision of therapeutic strategies according to individual tumor biology. This study was to investigate the correlations of c-erbB-2, epithelial growth factor receptor （EGFR）, and transforming growth factor-a （TGF-a） expression to recurrence of Dukes＇ A and B colorectal carcinoma. METHODS. The expression of c-erbB-2, EGFR and TGF-a in 26 specimens of Dukes＇ A and 62 specimens of Dukes＇ B colorectal adenocarcinoma was detected by SP immunohistochemistry. Of the 88 patients underwent curative resection between 1989 and 1999, 44 had recurrence, and 44 had not. The patients were followed up for at least 5 years or till recurrence. The tumor location, Dukes staging, age, sex, and depth of bowel wall invasion matched as closely as possible between the 2 groups. RESULTS： The overexpression rate of cerbB-2 was higher in recurrence group than in non-recurrence group （43.2% vs. 25.0%, P=0.072）; the overexpression rates of EGFR and TGF-a were significantly higher in recurrence group than in non-recurrence group （63.6% vs. 27.3%, P=0.001; 65.9% vs. 43.2%, P=0.032）. The co-overexpression rate of EGFR and TGF was significantly higher in recurrence group than in non-recurrence group （36.4% vs. 11.4%, P=0.006）. Multivariate analysis showed that the overexpression of EGFR was associated with postoperative recurrence of colorectal carcinoma. CONCLUSION： The expression of EGFR may be associated with postoperative recurrence of Dukes＇ A and B colorectal carcinoma.