大肠癌细胞粘附分子CD15表达与其临床及预后关系的研究

Expression of cell adhesion molecule CD 15 in colorectal carcinoma and its relation with clinical and prognosis

目的:研究大肠癌组织中的细胞粘附分子CD15表达及反应强度与肿瘤发生、分化、转移和预后的关系。方法:应用免疫组化法和图像分析技术,对90例大肠癌和10例正常大肠粘膜组织进行CD15表达和反应强度定量检测,并对其中53例患者进行随访。结果:75例大肠癌呈CD15阳性表达(83.3％).CD15阳性物质主要分布于正常大肠粘膜组织腺腔缘和大肠癌组织细胞膜和/或细胞浆。图像分析,CD15阳性细胞平均积分光密度值在低分化腺癌显著高于高、中分化腺癌和粘液腺癌(P<0.001);有淋巴结转移者显著高于无转移者(P<0.001);在获得3年以上随访材料中,死亡病例显著高于生存病例(P<0.01)。结论:CD15表达和反应强度对反映大肠癌组织发生、判断恶性程度、预测转移和评估患者预后有着重要意义。

Objective: To study the level of cell adhesion molecule CD15 expression in colorectal carcinoma and its related to carcinogenesis or differention or metastasis or prognosis. Method: CD15 expression and its optical density in colorectal carcinoma (n=90) and normal colorectal mucosa (n = 10) were quantitatively studied with immunohistochemical method combined with image analysis technique. Fifty -three patients have been followed up. Results: The positive rate of CD15 expression in colorectal carcinoma was 83. 3% (75/90). CD15 immunoreactivity in normal colorectal mucosae was mainly localized in the adenous cavity border, but in colorectal cancer tissues it was mainly localized in the cell membranes and/or cytoplasms. The mean integral optical density of CD15 positive cells in poorly differentiated adenocrcinoma was significantly higher that that in differentiated and mucinous ones (P<0. 001). It was markedly higher in patients with positive lyphatic nodes than that in negative ones (P<0. 001). With follow up for longer than 3 years, it was much lower in the alive cases than that in the death (P<0. 01). Conclusions :These findings indicate that changes of CD15 expression and its optical density is related to carcinogenesis, differ- entiation, invasion and metastasis of colorectal carcinoma. It may play an important role in predicting the prognosis of patients.