FAP癌变的危险因素分析及与COX-2、Survivin蛋白表达关系

Analysis of Risk Factors for Familial Adenomatous Polyposis and its Relationship with COX-2 and Survivin Protein Expression

目的探讨家族性腺瘤性息肉病(FAP)癌变危险因素,并分析环氧化酶-2(COX-2)、存活素(Survivin)蛋白表达水平在癌变过程中的作用,为防治FAP提供理论依据。方法回顾性分析笔者医院2014年1月~2018年1月确诊的73例FAP患者,根据患者有无癌变,分为FAP癌变组39例和FAP未癌变组34例,分析FAP相关结直肠癌发生的危险因素。免疫组化法检测病变组织COX-2、Survivin蛋白表达水平,分析其与FAP相关性。结果在73例患者中,39例经病理确诊发生癌变,癌变率为53.42%。癌变组患者的高危因素与性别无关(P>0.05),与发病年龄、腺瘤数量、腺瘤直径、腺瘤组织学类型有关,差异有统计学意义(P<0.05)。癌变组患者COX-2、Survivin蛋白表达阳性率分别为84.62%、74.36%,未癌变组COX-2、Survivin蛋白表达阳性率分别为61.76%、58.82%,癌变组患者COX-2及Survivin蛋白表达阳性率明显高于未癌变组,差异有统计学意义(P<0.05)。结论FAP患者恶变率与发病年龄、腺瘤数量、腺瘤直径、腺瘤组织学类型有关。COX-2、Survivin蛋白在癌变组患者中高表达,对于预测恶性结直肠癌早期病变有重要意义,可作为防治FAP的有效靶点。

Objective To discuss the risk factors of familial adenomatous polyposis (FAP), analyze the role of cyclooxygenase-2 (COX-2) and Survivin (Survivin) protein expression in carcinogenesis,and provide the basis for the prevention and control of FAP.Methods Retrospective analysis of 58 cases of FAP diagnosed in our hospital from January 2014 to January 2017 was performed.According to whether the patient has canceration or not,they were divided into FAP canceration group (30 cases) and FAP non canceration group (28 cases).Statistical analysis of risk factors for FAP associated colorectal cancer was performed.Immunohistochemistry was used to detect the expression levels of COX-2 and Survivin protein in the lesion tissues,and to analyze the correlation with FAP.Results In the 58 patients,30 were diagnosed by pathology and the rate of canceration was 51.75%.The risk factors of the cancer patients were not related to sex ( P >0.05),which were related to the age of the disease,the number of adenomas,the size of the adenoma and the histological type of the adenoma ( P <0.05),which had statistical significance.The positive rates of COX-2 and Survivin protein expression in the cancerous group were 83.3% and 73.3% respectively.The positive rate of COX-2 and Survivin protein in the non cancerous group was 60.7% and 57.1% respectively.The positive rate of COX-2 and Survivin protein expression in the cancerous group was significantly higher than that of the non cancerous group ( P <0.05).Conclusion The rate of malignancy in FAP patients is related to the age of onset,the number of adenomas,the size of adenoma,and the histological type of adenoma.The high expression of COX-2 and Survivin protein in the patients with cancer is of great significance for predicting the early lesions of malignant colorectal cancer and can be used as an effective target for the prevention and treatment of FAP.