直肠癌标本切缘翻译启动因子4E蛋白表达与预后的关系

Relationship of eIF4E protein of the operation specimen incisal margin to prognosis in rectal carcinoma

目的:研究直肠癌患者手术标本切缘翻译启动因子4E(eIF4E)蛋白表达与预后的相关性。方法:选择随访5年以上、临床资料齐全并经常规病理学检查切缘阴性的直肠癌标本共53例,采用LSAB免疫组织化学方法检测切缘和原发灶中eIF4E蛋白的表达,按切缘eIF4E蛋白阳性或阴性表达分为切缘eIF4E阳性组和切缘eIF4E阴性组,比较2组患者的随访结果。结果:直肠癌切缘和原发灶eIF4E表达阳性率分别为30.2%(16/53)和100%(53/53)。切缘eIF4E阳性表达患者复发转移和死亡10例(10/16,62.5%),切缘eIF4E阴性表达患者复发转移和死亡11例(11/37,29.7%),切缘eIF4E阳性组局部复发率高于阴性组(37.5%vs16.2%,P<0.05);远处转移率(18.7%vs10.8%)和死于肿瘤者2组比较差异无统计学意义(P>0.05)。37例切缘eIF4E阴性者生存5年以上32例,16例切缘eIF4E阳性者生存5年以上12例,5年累积存活率分别为69.8%、37.3%(P=0.007),平均生存时间分别是(112±7)个月和(43±9)个月。结论:直肠癌标本切缘常规病理检查癌细胞阴性,而eIF4E蛋白表达阳性患者复发率较高,预后较差。

Objective：To study the relationship of the expression of translation startup factor 4E（eIF4E）protein of the operation specimen incisal margin to prognos is in rectal carcinoma.Methods：Using LASB immunohistochemical technique to test the expression of eIF4E protein in the incisal margin and original focus from 53 negative cases in the conventional pathologic examination of the operation specimen incisal margin of the rectal carcinoma,and compared the survival rate between the positive group and the negative group.Results：The positive rate of the incisal margin and the original focus was respectively 30.2%（16/53）and 100%（53/53）.There were 10 cas es（10/16,62.5%）with recurrence,metastasis and death in the positive group.And 11 cases（11/37,29.7%）in the negative group.The local recurrence rate of the positive group was higher than that of the negative group,The statistic difference was significant（P〉0.05）.The difference between two groups in distant metastasis rate and the patients who died of carcinoma was not significant（P〈0.05）.There were 32 of 37 cases survived more than 5 years after the operation in negative group,and there were 12 of 16 cases survived more than 5 years in positive group.Using life-table method,the difference between two groups in 5 years survival rate was significant.Log rank value=12.13,P=0.007.The 5 years accumulative total survival rate was res pectively 69.8%and 37.3%.The mean survival time（month）were respectively 112±7 and 43±9.The difference between two groups was significant.Conclusion：Patient who is positive in expression of eIF4E protein and negative in the conventional pathologic cancer cell examination of the operation specimen incisal margin of the rectal carcinoma has a higher recrudescence rate and poor prognosis.