CK7/CK20、MUC6、RARα在各类结直肠锯齿状病变中的表达及意义

Expression of CK7/CK20,MUC6 and RARα and their significance in various colorectal serrated lesions

目的探讨CK7、CK20、MUC6、维甲酸受体(RARα)在各类结直肠锯齿状病变中的表达及鉴别意义。方法应用免疫组化方法检测CK7、CK20、MUC6、RARα在44例增生性息肉(HP),45例传统锯齿状腺瘤(TSA),11例广基锯齿状腺瘤(SSA)中的表达情况,并以结直肠管状腺瘤、腺癌及正常黏膜组织作为对照。结果 CK7阳性率HP为45.4%,SSA为36.4%,TSA为22.2%。CK20在结直肠各组病变中阳性率均较高,表达无差异。统计学分析显示,HP与TSA比较CK7的阳性率差异显著。MUC6的阳性率在SSA中为36.4%,HP中为4.5%,TSA中为11.1%。RARα的阳性率在HP中为38.6%,SSA中为81.8%,TSA中为62.2%。统计学分析RARα的阳性强度在HP和CRC中差异显著,在各型锯齿状病变间则差异不显著。结论 CK7(+)对鉴别HP和TSA有一定意义;MUC6(+)有助于SSA的确诊;RARα在锯齿状病变和结直肠腺癌组织中的阳性强度比正常结直肠黏膜组织减弱,但对各类锯齿状病变的鉴别意义不大。

Objective To investigate the expression of CK7, CK20, MUC6 and RARα, and their significance in differential diagnosis of various serrated lesions of colorectum. Methods Immunohistoehemistry was used to detect the expression of CK7, CK20, MUC6, RARα in 44 case of hyperplastic polyps （ HP）, 45 cases of traditional serrated adenoma （ TSA）, and 11 cases of sessile serrated adenoma （SSA）. Normal mucosa, tubular adenoma （TA） and coloreetal cancer （CRC） were used as control. Results The positive rates of CK7 were 45.4%, 36. 4% , and 22. 2% in HP, SSA and TSA respectively, as compared with that in TA （20%） and CRC （25%）. The high expression of CK20 was observed in each group without significal difference between them. The expression of CK7 （ ＋ ） showed significant difference between HP and TSA groups. MUC6 positive rate in 11 cases of SSA was 36. 4% ; 44 cases of HP was 4. 5% ; 45 cases of TSA was 11.1%. RARα positive rate was 38.6% in HP group; 81. 8% in SSA and 62. 2% in TSA. There were no different expression of RARer in each groups of serrated lesions （ P 〉 0. 05 ）. Conclusion The positive expression of CK7 may help distinguish HP from SSA. MUC6 expression is higher in the SSA. The expression of MUC6 is higher in SSA than that in HP and TSA, which may be helpful in the diagnosis of SSA. RARα shows weaker expression in the serrated lesions and CRC than that in nomal colorectal mucosa, but there is no significance in the differential diagnosis of various serrated lesions.