紧密连接蛋白occludin、ZO-1在溃疡性结肠炎中的表达及其临床意义

Expression and clinical significance of tight junction protein occludin and ZO-1 in ulcerative colitis

目的研究溃疡性结肠炎患者肠道紧密连接蛋白occludin、ZO-1的表达及其临床意义。方法收集2014年1月—2017年10月在中国医科大学附属盛京医院住院的溃疡性结肠炎患者临床资料和组织标本作为观察组,共80例,手术切除后经病理学证实的正常断端结肠组织20例,作为对照组。观察组按照Mayo临床评分(MCS)分为临床缓解组、轻度活动期组、中度活动期组、重度活动期组。免疫组织化学法检测肠道紧密连接蛋白occludin、ZO-1表达情况,并分析其与临床参数的相关性。结果 MCS和Mayo内镜评分(MCSe)在临床缓解组、轻度活动期组、中度活动期组、重度活动期组呈上升趋势,各组间差异均具有统计学意义(P<0.05)。与对照组比较,各观察组均显著升高(P<0.05),Geboes指数在各组中呈上升趋势,各组间差异均具有统计学意义(P<0.05)。与对照组比较,紧密连接蛋白(occludin和ZO-1)在观察组中的表达下降。ZO-1、occludin的表达与MCS、MCSe、Geboes指数、C-反应蛋白(CRP)呈负相关。结论紧密连接蛋白ZO-1、occludin可能会成为评估溃疡性结肠炎患者肠道炎症程度和预测黏膜愈合的指标。

Objective To study expression and clinical significance of intestinal tight junction（TJ） protein occludin and ZO-1 in patients with ulcerative colitis（UC）. Methods The clinical data and colonic biopsies of UC in Shengjing Hospital of China Medical University from January 2014 to October 2017 were collected as the experimental group, and 80 cases were treated by pathology, and 20 cases of normal distal colon after resection were confirmed as the control group. The experimental group was divided into clinical remission group, mild activity group, moderate activity group, and severe activity stage group according to Mayo clinical score（MCS）. The expressions of TJ proteins which included occluding and ZO-1 were assessed by immunohistochemistry, and its correlation with clinical characteristics were also analyzed. Results MCS and Mayo endoscopic subscore（MES） showed an upward trend in the clinical remission group, the mild activity period group, the moderate activity stage group, and the severe active stage group, and the differences were statistically significant（P〈0.05）. Compared with the control group, all experimental groups were significantly decreased（P〈0.05）, and the Geboes indexes in the remission group, the mild active period group, the moderate active stage group, and the severe active stage group were increased, and the differences were statistically significant（P〈0.05）. Compared with the control group, the expressions of TJ protein（occludin and ZO-1） were increased in the experimental group. The expressions of ZO-1 and occludin were negatively correlated with MCS, MCSe, Geboes index, and C-reactive protein（CRP）. Conclusion TJ proteins（Zo-1 and occludin） might be an potential indicator of intestinal inflammation and prognosis of UC.