150例结直肠癌浸润深度与淋巴结转移情况的临床病理研究

A clinicopathological study of 150 cases of colorectal cancer depth of invasion and lymph node metastasis

目的探讨结直肠癌浸润深度与淋巴结转移的关系以及CD44v6、p53、nm23-H1和COX-2表达情况,为临床治疗和预后评估提供参考。方法回顾性分析150例结直肠癌患者的病理资料,统计结直肠癌浸润深度、临床分期与淋巴结转移之间的关系;采用免疫组化方法检测CD44v6、p53、nm23-H1和COX-2在结直肠癌患者癌及癌旁组织中的表达。结果淋巴结转移率随着结直肠癌浸润深度的加深而增加(P<0.05);结直肠癌分化程度越低,淋巴结转移率越大(P<0.05);不同结直肠癌浸润深度患者3年生存率比较差异有统计学意义(P<0.05);不同结直肠癌淋巴转移患者3年生存率比较差异有统计学意义(P<0.05);CD44v6、COX-2、p53、nm23-H1表达在性别、年龄、肿瘤大小、部位等之间差异无统计学意义(P>0.05);不同组织类型及不同Dukes分期CD44v6、COX-2、nm23-H1表达差异有统计学意义(P<0.05);CD44v6、COX-2、p53、nm23-H1表达与浆膜浸润有关(P<0.05);CD44v6、COX-2、p53、nm23-H1表达表达与淋巴结转移有关(P<0.05)。结论结直肠癌浸润深度、分化程度与淋巴结转移相关,结直肠癌浸润深度、淋巴结转移与患者3年生存率相关,CD44v6、COX-2、p53、nm23-H1可作为预测结肠癌患者预后的指标。

Objective To investigate the depth of invasion of colorectal cancer with lymph node metastasis and the ex- pression of CD44v6,p53,nm23-H1 and COX-2,in order to provide clinical basis for treatment and prognosis. Methods The pathological datas of 150 cases with colorectal cancer was retrospectively analyzed,statistics was performed on the depth of invasion,clinicalthe relationship between the period and lymph node metastasis;the colorectal expression of CD44v6,p53,nm23-H1 and COX-2 in cancer and adjacent tissues of patients with rectal cancer were detected by im- munohistochemistry. Results Lymph node metastasis rate increased along with the deepening of the depth of invasion of colorectal cancer （P〈0.05）;the lower the degree of differentiation of colorectal cancer,the higher of the lymph node metastasis rate（P〈0.05）;the differences of 3-year survival rate in different colorectal cancer infiltration were all statisti- cally significant（P〈0.05）;the differences of 3-year survival rate in different lymph node metastasis were all statistically significant （P〈0.05）;the differences of CD44v6,COX-2,p53 and nm23-H1 expression between gender,age,tumor size and location were all not significant difference （P〉0.05）;the differences of CD44v6, COX-2,p53 and nm23-H1 expres sion in different histological types and Dukes stages were all statistically significant （P〈0.05）;CD44v6,COX-2 and nm23-H1 expression had a relationship with serosal invasion （P〈0.05）;CD44v6 COX-2,p53 and nm23-H1 expression had a relationship with lymph node metastasis （P〈0.05）. Conclusion Lymph node metastasis of colorectal cancer have relationship with depth of invasion,degree of differentiation.Colorectal cancer depth of invasion,lymph node metastasis related to the 3-year survival of patients.CD44v6,COX-2,p53,nm23-H1 can be used as prognostic indicators of pa- tients with colon cancer prediction.