FHL1和Smad4在结直肠癌中的表达及与肝转移的关系

Expression of FHL1 and Smad4 in colorectal cancer and its correlation with liver metastasis

目的探讨FHL1和Smad4在结直肠癌组织中的表达及与结直肠癌肝转移的相关性。方法选择结直肠癌患者112例,分为肝转移组及无肝转移组,应用免疫组织化学法检测FHL1和Smad4在结直肠癌及癌旁组织中的表达,分析两者在结直肠癌中的表达情况,及与肝转移的相关性。结果在结直肠癌组织中,FHL1的阳性表达率为20.5%(23/112),在癌旁组织中阳性表达率为94.6%(106/112),Smad4在两种组织中的阳性表达率分别为14.3%(16/112),96.4%(108/112),差异均有统计学意义(P均<0.05);无肝转移组中Smad4和FHL1的阳性表达率明显高于肝转移组中Smad4和FHL1的阳性表达率,差异有统计学意义(均P<0.05)。单因素分析结果提示结直肠癌临床分期、淋巴结转移、FHL1及Smad4表达与肝转移相关(均P<0.05),多因素logistic回归分析显示FHL1及Smad4蛋白表达是结直肠肝转移的独立危险因素。Spearman相关分析显示FHL1蛋白表达与Smad4呈正相关(r=0.462,P<0.05)。结论结直肠癌中FHL1及Smad4低表达与肝转移相关,是结直肠癌肝转移的独立影响因素,可作为预测结直肠癌肝转移的生物学指标。

Objective To detect FHL1 and Smad4 expression in colorectal cancer and to investigate its correla- tion with colorectal cancer liver metastasis（CRLM）. Methods One - hundred and twelve cases with colorectal cancer were enrolled and divided into two groups based on presence of liver metastasis. Immunohistochemical staining was used to detect the expression of FHL1 and Smad4 in resection specimens of colorectal cancer tissue and adjacent tissue. Correla- tion of these expressions with CRLM was analyzed. Results FHL1 positive expression rate in tumor tissues of colorectal cancer was 20. 5% （23/112）, which was lower than that in adjacent tissues （94. 6%, P 〈 0. 05 ）. Positive expression rate of Smad4 in colorectal cancer was lower than that in adjacent tissues （ 14. 3% % vs 96. 4%, P 〈0. 05 ）. Expression of FHL1 and Smad4 in patients without liver metastasis was significantly higher than that in patients with liver metastasis. Single factor analysis showed that CRLM was associated with expression of FHL1 and Smad4, clinical staging and lymph node metastasis （ all P 〈 0. 05）. Multivariate logistic regression analysis further indicated that low expression of FHL1 and Smad4 was an independent risk factor in CRLM. The expression of FHL1 and Smad4 was positively correlated in Spearman relative analysis （r = 0. 462, P 〈 0. 05） . Conclusion Low expression of FHL1 and Smad4 are associated with CRLM, and are independent risk factors of CRLM. They may be novel biomarkers to predict liver metastasis of colorectal carcinoma.