表皮-钙黏附素和Snail蛋白的表达与大肠癌侵袭转移及预后的关系

Relationship between E-CD and Snail expressions and tumor invasion, metastasis and prognosis in colorectal cancer

目的研究表皮-钙黏附素（E-CD）和Snail蛋白在大肠癌组织中的表达及其与大肠癌侵袭、转移和预后之间的关系。方法采用免疫组化EnVision法，检测E-CD和Snail蛋白在30例正常大肠黏膜、30例大肠腺瘤及142例大肠癌组织中的表达。结果E-CD蛋白在正常大肠黏膜组织中的强阳性表达率为90．0％，明显高于其在大肠腺瘤和大肠癌组织中的强阳性表达率（63．3％和41．5％，P〈0．05）。Snail蛋白在大肠癌组织中的阳性表达率为52．1％，明显高于其在正常大肠黏膜和大肠腺瘤组织中的阳性表达率（6．7％和26．7％，P〈0．05）。E-CD蛋白的表达与大肠癌的分化程度、浸润深度、静脉侵犯、淋巴管侵犯、淋巴结转移以及Duke’s分期有关（均P〈0．05），而与患者的年龄、性别、肿瘤大小以及病理组织学类型无关（均P〉0．05）。Snail蛋白的表达与大肠癌的分化程度、浸润深度、静脉侵犯、淋巴管侵犯、淋巴结转移、病理组织学类型以及Duke’S分期有关（均P〈0．05），而与患者的年龄、性别以及肿瘤大小无关（均P〉0．05）。E—CD蛋白与Snail蛋白在大肠癌组织中的表达呈负相关（r=-0．508）。E—CD蛋白阳性表达者的术后l、3和5年生存率明显高于阴性表达者（P〈0．05），Snail蛋白阴性表达者的术后1、3和5年生存率明显高于阳性表达者（P〈0．05）。淋巴结转移、Duke’s分期、E-CD和Snail蛋白的表达可作为大肠癌独立的预后指标（均P〈0．05）。结论E-CD和Snail蛋白的表达与大肠癌的侵袭、转移和预后明显相关，E-CD蛋白表达降低和Snail蛋白表达增强的大肠癌患者病期晚、预后差。

Objective To study the E-CD and Snail expressions in colorectal cancer and their relationship with colorectal cancer invasion, metastasis and prognosis. Methods Immunohistochemical staining （EnVision） was used to detect the E-CD and Snail expressions in 30 normal colorectal mucosa, 30 colorectal adenoma and 142 colorectal cancer tissues. Results E-CD in the normal colorectal mucosa was strongly positive expressed （90.0%）, significantly higher than that in colorectal adenomas （63.3%） and colorectal cancer tissues （41.5%）. E-CD expression was significantly related to tumor differentiation, invasion depth, vascular invasion, lymph node metastasis and Dukes＇ stage （P 〈0. 05）, but not to the patients＇ age, gender, tumor size and tumor histological type （ P 〉 0.05 ）. The 1 -, 3- and 5-year survival rates of the E-CD positive patients with colorectal cancer were significantly higher than that in E-CD negative patients. The positive expression rate of Snail in colorectal cancer tissues （52.1% ） was significantly higher than that in normal colorectal mucosa （6.7%） and colorectal adenomas （26.7% ,P 〈 0.05）. The snail expression was significantly correlated to tumor histological type, differentiation, invasion depth, vascular invasion, lymph node metastasis and Duke＇s stage （P 〈 0.05 ） , but not to patients＇ age, sex and tumor size （P 〉 0. 05 ）. The 1-, 3- and 5-year survival rates of Snail negative patients with colorectal cancer was significantly higher than that in patients with positive expression （ P 〈 0.05 ）. The expressions of E-CD and Snail in colorectal cancer tissues were inversely correlated （ P 〈 0. 05 ）. Cox multivariate analysis showed that E-CD and Snail can be used as independent prognostic indicators （P 〈 0.05）. Conclusion E-CD and Snail expressions in colorectal cancer are related to the tumor invasion, metastasis and prognosis. Low expression of E-CD and high expression of Snail are related to the advanced stage, and poor prognosis in colorectal cancer patients. E-CD and Snail can be used as independent prognostic indicators.