生存素、骨桥蛋白在大肠腺瘤癌变过程中的表达

Expression of survivin and osteopotin in the canceration of colonic adenomas

目的:观察生存素(survivin)、骨桥蛋白(osteopotin,OPN)在大肠正常黏膜、低危性腺瘤、高危性腺瘤及癌变的腺瘤中的表达,探讨survivin、OPN在大肠腺瘤癌变以及早期大肠癌诊断中的价值。方法:按照2006年美国《大肠息肉切除术后随访指南》诊断标准,对经肠镜检查并经病理证实的164例大肠腺瘤进行危险分层,选取78例大肠腺瘤组织蜡块,其中30例低危性大肠腺瘤,40例高危性大肠腺瘤,8例癌变的大肠腺瘤;另选取20例正常的大肠黏膜组织蜡块,利用免疫组化S-P法染色,检测survivin和OPN在各组的表达情况。结果:suvivin在大肠正常黏膜、低危性腺瘤、高危性腺瘤、癌变的腺瘤间表达的阳性率差异有统计学意义(P<0.01)。OPN在正常大肠黏膜与低危性腺瘤中表达的阳性率无统计学意义(P>0.05),在高危性腺瘤和癌变的腺瘤中表达的阳性率高于正常大肠黏膜(P<0.05和P<0.01),而低危性腺瘤和高危性腺瘤OPN表达阳性率与癌变的腺瘤相比,差异均有统计学意义(P<0.05)。结论:survivin在大肠正常黏膜、低危性大肠腺瘤、高危性大肠腺瘤及癌变的大肠腺瘤中的表达逐渐升高,提示survivin是大肠癌发生的早期事件,可能成为诊断大肠腺瘤及大肠腺瘤癌变的一个参考指标。OPN在低危性大肠腺瘤、高危性大肠腺瘤及癌变的大肠腺瘤中的表达逐渐升高,提示OPN可能成为诊断大肠腺瘤癌变的一个参考指标。

Objective：To observe the expressions of survivin and osteopotin（OPN） in normal tissues,low risk colonic adenoma,high risk colon adenoma and cancerated adenoma, and to investigate the value of survivin and OPN in the canceration of colorectal adenoma and the diagnosis of colorectal cancer at the early stage. Methods： According to the diagnostic criteria of ＂the Guidelines for Colonoscopy Surveillance after Polypectomy＂ in 2006, the risk stratification of 164 cases of colorectal adenoma who had undergone colonoscopy and verified by pathology was carried out. Seventy-eight cases of colon adenoma including 30 cases of low risk colon adenoma,40 cases of high risk colon adenoma,8 cases of cancerated adenoma and 20 cases of normal tissue were chosen to identify the expressions of survivin and OPN by S-P immunchistochmical method in each group ; related analysis was made with reference to the clinicopathologic features. Results： The positive expressions of survivin in normal tissues, low risk colon adenoma, high risk colon adenoma and cancerated adenoma were obviously different（P 〈0.01 ）. The positive rates of OPN in normal tissues and low risk colon adenoma have no difference（P 〉 0.05 ）. The positive rate of OPN in high risk colon adenoma and cancerated colon adenoma was higher than that in normal tissues（P 〈0.05 and P 〈0.01 ）. The positive rate of OPN in low risk colon adenoma and high risk colon adenoma was obviously lower compared with that of cancerated colon adenoma （ P 〈 0.05 ）. Conclusions ： The expression of survivin in normal tissues,low risk colon adenoma, high risk colon adenoma and cancerated adenoma increases gradually, which indicates that survivin may be an early event in the development of colorectal cancer. It can be regarded as a reference index in colon adenoma and adenoma canceration. The expression of OPN increases gradually in low risk colon adenoma, high risk colon adenoma and cancerated adenoma, indicating that OPN may act as a reference index in colorectal adenoma canceration.