CD44、NGAL、MIC-1在结直肠癌诊断及远期预后中的应用价值

The diagnostic value and long term prognosis of serum CD44,NGAL,MIC-1 in the colorectal cancer

目的探讨吞噬细胞糖蛋白-1(CD44)、中性粒细胞明胶酶相关载脂蛋白(NGAL)、巨噬细胞抑制因子1(MIC-1)在结直肠癌诊断及远期预后中的应用价值。方法选取2011年1月—2012年12月武汉市第七医院普外科收治的60例经病理组织学确诊为结直肠癌患者的病理组织为研究组,另收集其癌旁正常组织(距肿瘤>5 cm)为对照组,应用免疫组化法测定2组CD44、NGAL、MIC-1表达水平,并分析CD44^+、NGAL、MIC-1与患者临床病理资料及预后的关系。结果研究组CD44、NGAL、MIC-1阳性表达率分别为86.67%、80.00%、70.00%,均显著高于对照组的16.67%、20.00%、13.33%,差异均有统计学意义(x^2=58.865、43.200、39.634,P<0.01)。CD44表达与年龄、分化程度、浸润程度、淋巴转移有关(x^2=7.552、9.650、6.593、6.154,P<0.05),NGAL表达与浸润深度、肿瘤分期、淋巴结转移有关(x^2/U=10.714、15.000、10.000,P<0.05),MIC-1与肿瘤分化程度、浸润深度、肿瘤分期及淋巴结转移有关(x^2/U=12.862,6.612,15.556,17.143,P<0.05)。CD44阳性表达者3年生存率为53.33%(32/60),低于CD44阴性表达者100.00%(8/8)(x^2=6.347,P=0.012);NGAL阳性表达者3年生存率为60.42%(29/48),低于NGAL阴性表达者91.67%(11/12)(x^2=4.219,P=0.040);MIC-1阳性表达者3年生存率为57.14%(24/42),低于MIC-1阴性表达者88.89%(16/18)(x^2=5.714,P=0.017)。结论 CD44、NGAL、MIC-1表达与结直肠癌发生、进展及生存率有密切的关系,联合测定三者表达情况将有助于结直肠癌临床诊断及预后评价。

Objective To investigate the phagocyte glycoprotein 1（CD44）,neutrophil gelatinase associated lipocalin（NGAL）,macrophage inhibitory factor 1（MIC-1） application in diagnosis and long-term prognosis in colorectal cancer.Methods Sixty cases of histological confirmed colorectal cancer patients were selected as study group,and collected 60 normal tissues（from the tumor 〉 5 cm） enrolled as the control group from January 2012 to December 2015.The expression levels of CD44,NGAL,MIC-1 were measured with immunohistochemical method and the relationships of CD44,NGAL,MIC-1with the clinicopathological data and prognosis were analyzed.Results The study group CD44,NGAL,MIC-1 positive expression rates were 86.67%,80.00%,70.00%,significantly higher than that of control group 16.67%,20.00%,13.33%,the differences were statistically significant（x2=58.865,43.200,39.634,P 〈0.05）.The expression of CD44 and age,the degree of infiltration,degree of differentiation,lymph node metastasis（x2=7.552,x2=9.650,x2 =6.593,x2= 6.154,P 〈 0.05）,the expression of NGAL and the depth of tumor invasion,tumor stage,lymph node metastasis（x2/U =10.714,x2/U =15.000,x2/U =10.000,P 〈0.05）,MIC-1 and the degree of tumor differentiation,tumor stage,invasion depth and lymph node metastasis（x2/U = 12.862,x2/U =6.612,x2/U = 15.556,x2/U = 17.143,P 〈0.05）.The positive expression of CD44 in the 3 year survival rate was 53.33%（32/60）.lower than the negative expression of CD44s100.00%（8/8）（x2 =6.347,P =0.012）;the positive expression of NGAL in the 3 year survival rate was 60.42%（29/48）,lower than the negative expression of NGALs 91.67%（11/12）（x2=4.219,P =0.040）;the positive expression of MlC-1’s 3 year survival rate was 57.14%（24/42）.lower than that of MIC negative expression in 88.89%（16/18）（x2=5.714,P =0.017）.Conclusion The expression of CD44.NGAL.MIC-1 has a close relationship with the occurrence,progression and survival rate of colorectal cancer,and the combined detection of the expression of the three cases will contribute to the clinical diagnosis and prognosis of colorectal cancer.