结直肠癌HER2及Ki-67表达的关系及预后因素分析

Relationship between HER2 and Ki-67 expression in colorectal cancer and prognostic factors analysis

目的探讨人表皮生长因子受体2(HER2)和细胞增殖核抗原(Ki-67)在结直肠癌发病机制中的作用及其对患者预后的影响。方法应用免疫组织化学法检测71例结直肠癌组织和30例癌旁正常组织中HER2、Ki-67的表达情况,分析其表达与临床病理特征及预后的关系。结果 HER2在癌组织中阳性表达率(32.4%)高于癌旁组织(10.0%),Ki-67在癌组织中阳性表达率(85.9%)高于癌旁组织(6.7%),差异有统计学意义(P<0.05)。HER2表达与肿瘤分化程度、有无淋巴结转移、淋巴结转移数目、TNM分期有关(P<0.05);Ki-67表达与肿瘤浸润深度、有无淋巴结转移、淋巴结转移数目、TNM分期有关(P<0.05)。HER2、Ki-67在结直肠癌组织中表达呈正相关(r=0.515,P=0.001)。HER2阳性患者和阴性患者术后5年无病生存率分别为48.4%、80.8%,差异有统计学意义(P<0.05);Ki-67高表达患者和低表达患者术后5年无病生存率分别为56.5%、85.5%,差异有统计学意义(P<0.05)。HER2阳性患者和阴性患者术后5年生存率分别为60.9%、80.8%,差异有统计学意义(P<0.05);Ki-67高表达患者和低表达患者术后5年生存率分别为63.9%、85.5%,差异有统计学意义(P<0.05)。单因素分析显示,肿瘤分化程度、浸润深度、有无淋巴结转移、转移淋巴结数目、TNM分期、HER2和Ki-67表达情况与患者的预后均有关(P<0.05)。Cox多因素分析结果显示,浸润深度、TNM分期为影响患者预后的独立因素。结论在结直肠癌发生、发展过程中伴随着HER2和Ki-67的表达,HER2和Ki-67阳性者5年无病生存率及5年生存率明显降低。

Objective To investigate the role of HER2 and Ki-67 in colorectal cancer pathogenesis and their influence on the prognosis in the patients with colorectal cancer.Methods The expressions of HER2 and Ki-67 proteins in colorectal cancer tissues from 71 cases of colorectal cancer and 30 cases of para-cancerous normal tissues were detected by using the immunohistochemistry.The expressions of HER2,Ki-67 and their clinicopathological parameters and prognostic significance were also analyzed.Results The positive expression rate of HER2 in colorectal cancer tissue(32.4%)was higher than that in para-cancerous normal tissues(10.0%);the positive expression rate of Ki-67 in colorectal cancer tissue(85.9%)was significantly higher than that in para-cancerous normal tissues(6.7%),the difference was statistically significant(P<0.05).The expression of HER2 in colorectal cancer tissues was correlated with tumor differentiation degree,lymph node metastasis,number of lymph node metastasis and TNM staging(P<0.05).The expression of Ki-67 in colorectal cancer tissues was correlated with infiltration depth,lymph node metastasis,number of lymph node metastasis and TNM staging(P<0.05).HER2 in colorectal cancer tissues was positively correlated with Ki-67(r=0.515,P=0.001).The 5-year disease-free survival rates in the HER2 positive group and the HER2 negative group were 48.4%and 80.8%,the difference was statistically significant(P<0.05).The 5-year disease-free survival rates in the Ki-67 high expression group and the Ki-67 low expression group were 56.5%and 85.5%,the difference was statistically significant(P<0.05).The 5-year survival rate in the HER2 positive group and the HER2 negative group were 60.9%and 85.5%,the difference was statistically significant(P<0.05).The 5-year survival rate in the Ki-67 high expression group and the Ki-67 low expression group were 63.9%and 85.5%,the difference was statistically significant(P<0.05).The single factor analysis showed that tumor differentiation degree,infiltration depth,lymph node metastasis,number of lymph node metastasis,TNM staging,the expressions of HER2 and Ki-67 were related with prognosis in the patients with colorectal cancer(P<0.05).The Cox multivariate analysis results showed that tumor infiltration depth and TMN staging were the independent factors affecting prognosis in the patients with colorectal cancer.Conclusion The expressions of HER2 and Ki-67 are associated with the development of colorectal cancer.The 5-year disease-free survival rate and the 5-year survival rate in the patients with HER2 and Ki-67 positive become significantly decreased.