结直肠癌卵巢转移组织中CDX-2与CK7和CK20的表达及其临床意义

The Expression and Clinical Significance of CDX-2,CK7 and CK 20 in Ovarian Metastasis from Colorectal Carcinomas

目的:探讨结直肠癌卵巢转移组织中CDX-2与CK7和CK20的表达及其临床意义,为结直肠癌卵巢转移的诊断和治疗提供理论依据。方法:回顾性分析结直肠癌卵巢转移患者54例临床病理资料。采用免疫组织化学(SP法)检测和分析20例原发卵巢癌及结直肠癌卵巢转移患者癌组织中CDX-2、CK7和CK20的表达。对临床病理特征进行单因素及多因素分析。结果:CDX-2,CK7和CK20在原发性卵巢癌组织中的阳性表达率分别为0(0/20),95%(19/20),15%(3/20),在结直肠癌卵巢转移组织中的阳性表达率分别为100%(20/20),10%(2/20),90%(18/20),差异有统计学意义(P<0.05);Cox回归模型多因素分析结果显示:卵巢包块大小、转移发生时间、腹膜种植转移、卵巢转移灶是否切除、是否化疗是影响结直肠癌卵巢转移患者预后的独立危险因素(P<0.05)。卵巢包块大、卵巢转移灶未切除、同时性卵巢转移、伴有腹膜转移、未行化疗的结直肠癌卵巢转移患者生存期短,预后差。结论:通过检测原发卵巢癌及结直肠癌卵巢转移组织中CDX-2、CK7和CK20的表达,有助于鉴别诊断原发卵巢癌与结直肠癌卵巢转移;尽量创造卵巢转移灶切除的机会可能有助于提高结直肠癌卵巢转移患者生存期。

Objective： To investigate the expression levels and impact factors of CDX-2, CK7 and CK20 in ovarian tissue and prognostic factors, providing theoretical basis for diagnosis and treatment of ovarian metastasis from colorectal carcinomas. Methods： Retrospective data analysis of 54 patients with ovarian metastasis from colorectal cancers. By immu- nohistochemistry, （streptavidin-perosidase） we detected the expression of CDX-2, CK7 and CK20 in ovarian carcinoma specimens from 20 cases of primary ovarian cancer and metastatic ovarian carcinoma from colorectal cancer. Univariate and Cox regression model multivariate analyses were performed to Clinical and pathological feature. Results： Expression rates of CDX-2, CK7 and CK20 were 0（0/20） ,95% （19/20）, 15% （3/20）in tissues of primary epithelial ovarian cancer, whereas 100% （ 20/20 ）, 10% （ 2/20）, 90% （ 18/20 ） in metastatic ovarian cancer. The difference shown statistical significance （ P 〈 O. 05 ）. Cox regression muhivariate analysis showed that the size of the ovarian mass, time of occurrence, peritoneal metastasis, resection of ovarian metastases and chemotherapy were independent factors for prognosis （ P 〈 0.05）. Patients with large ovarian mass, unresected ovarian metastases, simultaneous ovarian metastases, peritoneal metastasis and non-chemotherapy had poor prognosis. Conclusion ： Expression of CDX-2, CK7 and CK20 could help to differential diagnose primary ovarian cancer and metastatic ovarian cancer from colorectal adenocarcinoma. Resection of ovarian metastases could improve survival in these patients.