趋化因子受体CCR7及CXCR4在结肠癌组织中的表达及意义

Expression of chemokine receptor CCR7 and CXCR4 in human colorectal carcinoma and its significance

目的:观察趋化因子受体CCR7及CXCR4在结肠癌组织中的表达及与临床病理特征的关系,探讨其评价结肠癌侵袭转移及预后的意义。方法:对110例行结肠癌根治术的结肠癌组织标本采用免疫组织化学方法检测CCR7及CXCR4的表达。结果:CCR7、CXCR4在110例结肠癌组织中阳性表达率分别为59.1%和45.5%,其中淋巴结转移组表达率分别为90.8%、69.2%,无淋巴结转移组表达率分别为13.3%、11.1%,差异有统计学意义(P<0.05)。CCR7及CXCR4的表达与结肠癌浸润深度、淋巴结转移、肿瘤分期密切相关(P<0.05),与年龄、性别、肿瘤大小、组织学类型及分化程度无关(P>0.05)。CCR7判断结肠癌淋巴结转移的敏感性、特异性、阳性预测值及阴性预测值分别为90.8%、86.7%、90.8%、86.7%;CXCR4判断结肠癌淋巴结转移的敏感性、特异性、阳性预测值及阴性预测值分别为69.2%、88.9%、90.0%、66.7%;联合检测CCR7及CXCR4诊断结肠癌淋巴结转移的准确率为88.1%。结论:趋化因子受体CCR7及CXCR4与结肠癌淋巴结转移密切相关,联合检测CCR7及CXCR4对预测结肠癌淋巴结转移情况、评价预后、判定术后治疗方案具有指导价值。

Objective： To observe the expression of chemokine receptor CCR7 and CXCR4 in human colorectal carcinoma and its significance; so as to assess their expression with the metastasis and prognosis of colorectal carcinoma. Methods： Immunohistochemistry was used to detect the expression of chemokine receptor CCR7 and CXCR4 in 110 patients with colon cancer .The relationship between the CCR7 and CXCR4 expression and the clinic pathological characters was statis- tically analyzed. Results： CCR7 and CXCR4 expression were positively expressed in 59.1% and 45.5%of the patients. The high expression rate of CCR7 and CXCR4 in lymph node metastasis positive cases was 81 5% and 60.0% respectively, but the without lymph node metastasis positive cases were 26,7% and 24.4% respectively. The positive expression was significantety higher in the patients with lymph node metastasis than those non-lymph node metastasis （P〈O.O05）, and was also correlated with depth of invasion （P〈0.005） and TNM stage （P〈0.01）. but not with age, gender, tumor size, histological type or different degree. In the retrospective study, the sensitivity, specificity, positive predictive value （PPV） , negatively predictive value （NPV） of CCR7 express for lymph node metastasis were 90.8% ,86.7% ,90.8% ,86,7% respectively. The sensitivity, specificity, positive predictive value （PPV） , negatively predictive value （NPV） of CXCR4 express for lymph node metastasis were 69.2% ,88.9% ,90.0% ,66.7% respectively. Receiver operating characteristic （ROCk） analysis showed that the accuracy of the combined examination of CXCR4 and CCR7 expression in diagnosing lymph node metastasis was high. Conclusion： The expression of CCR7 and CXCR4 may be related to lymph node metastasis of colon cancer. Moreover, the combined examination of CCR7 and CXCR4 may be useful in predicting lymph node metastasis of colon cancer. Also the expression of CCR7 and CXCR4 could be helpful in prognosis after surgery of patients with colorectal carcinoma.