端粒酶逆转录酶在结直肠癌组织中的表达及其临床意义

Clinical and prognostic significance of hTERT expression in patients with colorectal cancer

目的探讨端粒酶逆转录酶(human telomerase reverse transcriptase,hTERT)在结直肠癌(colorectal cancer,CRC)和相应正常组织中mRNA的表达,分析hTERT mRNA与结直肠癌患者临床病理参数及预后的关系。方法以实时荧光定量PCR(quantitative real-time polymerase chain reaction,qRT-PCR)法检测42例结直肠癌组织及其相应正常组织中hTERT mRNA的表达,分析其与临床病理参数之间的关系,并结合临床随访资料分析其与结直肠癌患者预后的关系。结果hTERT mRNA在结直肠癌组织和正常组织均可表达,但结直肠癌组织中hTERT mRNA的表达水平明显高于相应正常组织,两者差异有统计学意义(P=0.011);在有淋巴结转移的结直肠癌中hTERT mRNA高表达率比无淋巴结转移结直肠癌明显增高(92.0%vs 52.9%,P=0.011);在结直肠癌临床TNMⅢ期/Ⅳ期中hTERT mRNA的高表达率明显高于Ⅰ期/Ⅱ期(92.3%vs 50.0%,P=0.006)。通过Kaplan-Meier分析,结直肠癌患者hTERT mRNA的低表达组和高表达组之间的生存曲线差异具有统计学意义(P=0.014),提示hTERT mRNA的高表达可能与预后不良相关。结论 hTERT不仅在结直肠癌的发生、发展中起重要作用,而且可能促进结直肠癌的浸润、转移,有望成为结直肠癌的预后标志物及治疗靶点。

Objective To investigate the expression profile of human telomerase reverse transcriptase（hTERT）in colorectal cancer （CRC）and to assess its clinical significance. Methods Quantitative real-time PCR was used to detect expression of hTERT mRNA both in colorectal cancer and in corresponding normal tissue. Expression data were correlated with clinicopathological features,and survival analysis was performed to assess the prognostic significance. Results The hTERT mRNA was expressed in both tumor and CRC tissue,but it was expressed at significantly higher levels in cancer tissue （P=0.011）. Upregulation of hTERT was significantly associated with lymph node involvement（P=0.011）and TNM stage（P=0.006）. Kaplan-Meier survival analysis of low vs. high expressers of hTERT revealed much lower survival among high expressers （P=0.014）. Conclusions The results of the current study suggest that hTERT may play an important role in onset of CRC,so the protein may have potential as a prognostic biomarker or even as a therapeutic target.