肿瘤标记物表达对A/B期结直肠癌患者预后的影响

Influence of expression of tumor markers on prognosis of patients with A/B-stage colorectal cancer

目的了解结直肠癌转移相关标记物过表达对A/B期患者预后的影响。方法收集2001至2002年65例结直肠癌的石蜡标本,用免疫组化染色检测CD44V6、MMP-2、COX-2、EGF、EGFR和VEGF的表达情况。比较阳性表达组和阴性表达组之间5年复发转移率的差异和多个肿瘤标记物过表达对预后的影响。结果A/B期结直肠癌中,CD44V6、EGF和EGFR蛋白阳性组的5年复发转移率分别为30.9%、38.1%和27.5%,显著高于阴性组的5年复发转移率8.3%、8.8%和11.8%（P=0.045、0.022和0.047）;有3个以上指标阳性组的5年复发转移率高于0～2个指标阳性组,而5年生存率低于0～2指标阳性组,差异均有显著性（P=0.019和0.030）。结论CD44V6、EGF和EGFR蛋白过表达与Dukes A/B期患者高复发转移相关,肿瘤转移标记物高表达越多,复发转移的机率越高,5年生存率越低。

Objective To evaluate the relationship between tumor marker over-expression and prognosis of the colorectal cancer（ CRC ） in Dukes A/B stage. Methods Paraffin-embedded specimens of 65 cases of CRC were collected to evaluate abnormal expression of CD44V6, MMP-2, COX-2, EGF, EGFR and VEGF using the method of immunhistochemistry（IHC）. The differences of 5-year recurrence and metastasis rates between positive expression group and negative group and the differences of prognosis affected by multitude tumor markers overexpression in the eolorectal cancer were compared. Results In Dukes A/B stage, the 5-year recurrence rates were 30. 9% , 38. 1% and 27. 5% in the positive expression groups and was 8.3%, 8.8% and 11.8% in the negative groups of CD44V6, EGF and EGFR respectively. In Dukes A/B stage, the more the positive tumor markers, the higher the possibility of the 5-year recurrence rate and the lower the 5-year survival rate. Conclusions The tumor markers CD44V6, EGF and EGFR were the prognostic indicators of CRC in Dukes A/B stage. Moreover, In Dukes A/B stage, the more the positive tumor markers, the higher the possibility of the 5-year recurrence rate and the lower the 5-year survival rate.