结直肠癌患者肿瘤间质中骨膜素的表达水平及其临床意义

Expression levels of periostin in tumor stroma of patients with colorectal cancer and its clinical significance

目的研究结直肠癌患者肿瘤间质中骨膜素表达水平及其在结直肠癌患者预后判断中的临床意义。方法以寿光市人民医院2009年7月至2012年12月连续收治的220例结直肠癌患者为研究对象。收集手术切除的肿瘤样本,采用免疫组化法测定肿瘤间质中骨膜素表达水平,采用χ^2检验比较骨膜素高表达及低表达患者的临床病理特征差异,Cox回归分析评价骨膜素表达水平与患者5年肿瘤特异性生存率(CSS)及无进展生存率(PFS)的关系。结果肿瘤间质中骨膜素高表达与结直肠癌患者的肿瘤生长方式(χ^2=7.455,P<0.01)、TNM分期(χ^2=46.334,P<0.01)、分化程度(χ^2=6.863,P<0.01)、肿瘤出芽(χ^2=16.570,P<0.01)显著相关。骨膜素高表达患者5年CSS(χ^2=77.185,P<0.01)和5年PFS(χ^2=125.838,P<0.01)均低于骨膜素低表达组患者。肿瘤间质中骨膜素高表达是结直肠癌患者5年CSS(HR:1.53,95%CI:1.14~2.09,P<0.01)和5年PFS(HR:1.40,95%CI:1.08~1.83,P<0.01)的独立预后因素。结论肿瘤间质中骨膜素高表达可作为结直肠癌患者不良预后的独立因素。

Objective To investigate the expression levels of periostin in tumor stroma of patients with colorectal cancer and its significance in evaluating prognosis.Methods A total of 220 patients with colorectal cancer who admitted into Shouguang People’s Hospital from July 2009 to December 2012 were selected.Tumor samples were collected from patients by surgical resection.The expression of periostin in tumor stroma was determined by immunohistochemistry.Theχ^2 test was used to compare the clinicopathological features of patients with high and low expression of periostin.Cox regression analysis was used to evaluate the relationship between the expression of periostin and 5-year cancer-specific survival(CSS)and progression-free survival(PFS)of patients.Results High expression of periostin in tumor stroma was significantly associated with tumor growth pattern(χ^2=7.455,P<0.01),TNM staging(χ^2=46.334,P<0.01),differentiation grade(χ^2=6.863,P<0.01)and tumor budding(χ^2=16.570,P<0.01)of patients.The 5-year CSS(χ^2=77.185,P<0.01)and 5-year PFS(χ^2=125.838,P<0.01)of patients with high expression of periosteum were lower than those of patients with low expression of periosteum.High expression status of periostin in tumor stroma was an independent prognostic parameter implicating poor 5-year CSS(HR:1.53,95%CI:1.14-2.09,P<0.01)and 5-year PFS(HR:1.40,95%CI:1.08-1.83,P<0.01).Conclusions High expression status of periostin in tumor stroma may be an independent factor for predicting poor prognosis of patients with colorectal cancer.