结直肠癌组织CDX2、p21WAF1蛋白表达与中医虚证相关性的研究

Relation between expression of CDX2 and p21WAF1 protein in colorectal cancer and TCM deficiency syndrome

目的研究结直肠癌组织CDX2及p21WAF1蛋白表达，探讨其在结直肠癌发生发展中的病理意义。在此基础上研究CDX2及p21WAF1蛋白表达与中医虚证的相关性。方法以酒泉市人民医院的结直癌手术切除标本45例为研究对象，收集病理资料进行辨证分型。采用免疫组化EliVision法检测癌组织、癌旁组织中CDX2、及p21WAF1的表达。结果CDX2、p21WAF1在结直肠癌组织中的阳性率分别为86．7％、35．6％。结直肠癌组织中CDX2与p21WAF1表达无相关性。p21WAF1蛋白表达在虚证组（11．76％）明显低于实证组（41．67％）和虚实夹杂证组（56．25％），其差异有统计学意义（X^2=7．385，P=0．025）。CDX2蛋白表达在虚证、实证、虚实夹杂组间差别无统计学意义。结论CDX2及D21WAF1阳性率在癌及切缘组织中有显著性差异，二基因可能与结肠癌发生发展相关。CDX2与p21WAF1之间无相关性。p21WAF1表达降低提示结直肠癌患者预后不良。p21WAF1表达在虚证组中明显低于实证、虚实夹杂证组。

Objective To study the expression of CDX2 and p21WAF1 protein in colorectal cancer and its correlation with the progression of colorectal cancer., and to explore the correlativity of CDX2 and p21WAF1 genes expression with TCM deficiency Syndrome. Methods Immunohistochemical method was used to detect the expressions of CDX2 and p21WAF1 in 45 patients of colorectal carcinoma tissues and peri-canccrous tissues, who received the treatment at the People＇s Hospital of Jiuquan City between April, 2000 and August, 2005. According to TCM syndrome differentiation, the patients were divided into sthenia syndrome group and asthenia syndrome group and sthenia-ashenia syndrome group. Analyze the Correlation between CDX2 and p21WAF1 expression and TCM syndrome. Results The positive rate of CDX2 and p21WAF1 was 86.7% and 35.6% respectively in colorectal carcinoma tissues. There was no correlation between CDX2 and p21WAF1 in colorectal cancer tissues. The positive rate of p21WAF1 was different in three groups, which was much lower in the asthenia syndrome group （11.76%） than the sthenia syndrome group （41.67%）and sthenia-asthenia syndrome group（56.25%）. Conclusion CDX2 and p21WAF1 positive rate was different in cancer tissue and resection margin. The two genes may be associated with colorectal cancer development. CDX2 was not correlated with p21WAF1 The lower expression of p21WAF1 indicates poor prognosis. The positive rate of p21WAF1 was different between deficiency syndrome and excess syndrome, p21WAF1 is probably a marker to determine the asthenia and sthenia syndrome. Asthenia syndrome indicates a poor prognosis.