成人大肠腺瘤伴鸡皮样黏膜改变的临床意义

Biological characteristics of colorectal adenoma with chicken-skin mucosa and its clinical significance

目的研究伴鸡皮样黏膜（CSM）改变的成人大肠腺瘤生物学特性及其临床意义。方法采用免疫组化sP法及酶联免疫吸附试验（ELISA）检测正常大肠黏膜、伴CSM的大肠腺瘤、不伴CSM的大肠腺瘤和大肠腺瘤癌变标本中代表细胞增殖的标志物Ki．67、COX．2和细胞凋亡相关因子survivin、caspase-3蛋白的表达情况。结果免疫组化结果提示在大肠腺瘤癌变组织、伴CSM的大肠腺瘤、不伴CSM的大肠腺瘤及正常大肠黏膜中Ki-67、COX-2的表达呈递减趋势，而survivin和caspase-3的表达呈递增趋势。蛋白质定量分析（ELISA法）结果提示Ki-67、COX-2、survivin、caspase．3含量在伴CSM的大肠腺瘤与腺瘤癌变组织间比较差异均无统计学意义（P〉0．05），伴CSM的大肠腺瘤与不伴CSM的大肠腺瘤比较差异均有统计学意义（P〈0．05），正常大肠黏膜与伴CSM的大肠腺瘤、大肠腺瘤癌变组织间比较差异均有统计学意义（P〈0．05）。结论伴CSM的大肠腺瘤具有有别于不伴有CSM的大肠腺瘤的生物学特性，其细胞增殖活跃而调亡受抑制，易发生癌变。

Objective To explore the biological features of colorectal adenoma with chicken-skin mucosa （CSM） and its clinical significance. Methods Expression of cell proliferation markers （ Ki-67 and COX-2） and apoptosis-related factors （survivin and caspase-3 ） in normal colorectal mucosa, eolorectal ade- noma without CSM, colorectal adenoma with CSM and coloreetal adenocarcinoma were detected by immuno- histochemistry SP method and enzyme-linked immunosorbent assay （ELISA）. Results Immunohistochemi- cal results revealed a decreased trend in expressions of Ki-67 and COX-2 from colorectal adenocarcinoma through colorectal adenoma with and without CSM to normal eoloreetal mucosa, while the expressions of sur- vivin and easpase-3 showed an increased trend. By ELISA, the expressions of Ki-67, COX-2, surviving and caspase-3 showed no significant difference （ P 〉 0.05 ） between colorectal adeuoma with CSM and colorectal adenocarcima, while these variables were significantly different （ P 〈 0. 05 ） between colorectal adenoma with and without CSM, so as well between normal colorectal mucosa and other 3 groups. Conclusion The bio- logical characteristics of colorectal adenoma with CSM are different from those without, showing an activated cell proliferation and inhibited cell apoptosis with increased carcinogenesis risk.