癌组织及外周血中CD44、PLCEl、甲基化Sept9基因及DNA错配修复蛋白表达水平与结直肠癌病理分期及预后的相关性分析

Correlation of the expressions of CD44,PLCEl,methylated Sept9 gene and DNA mismatch repair protein in cancer tissues and peripheral blood with the pathological stage and prognosis of colorectal cancer

目的探讨癌组织及外周血中白细胞分化抗原分化簇第44号(CD44)、磷酯酶Cεl(PLCEl)、甲基化Sept9基因及DNA错配修复蛋白表达水平与结直肠癌病理分期及预后的相关性。方法将2013年3月至2015年5月在西宁市第二人民医院确诊为结直肠癌的56例患者设为观察组,将同期于我院体检的55名健康成年人设为对照组。比较两组甲基化Sept9基因、CD44、PLCEl及DNA错配修复蛋白表达情况,分析以上指标在结直肠癌患者中的临床分布特点并进行相关性检验,比较不同甲基化Sept9基因、CD44、PLCEl及DNA错配修复蛋白表达情况并分析其与结直肠癌患者的预后相关性。结果观察组甲基化Sept9基因及CD44表达阳性率、PLCEl表达阴性率、DNA错配修复蛋白表达缺失率高于对照组(P<0.05)。甲基化Sept9基因、PLCEl及DNA错配修复蛋白在不同肿瘤浸润深度、肿瘤大小、病理分期及有无淋巴结转移结直肠癌患者中的表达差异有统计学意义(P<0.05)。CD44在不同肿瘤浸润深度、病理分期及有无淋巴结转移结直肠癌患者中的表达差异有统计学意义(P<0.05)。PLCEl与结直肠癌的浸润深度、病理分期呈负相关(r=-0.367,P=0.045;r=-0.522,P=0.008);甲基化Sept9基因与浸润深度、病理分期、淋巴结转移呈正相关(r=0.715,P=0.026;r=0.471,P=0.032;r=0.453,P=0.010),CD44与浸润深度、病理分期、淋巴结转移呈正相关(r=0.349,P=0.007;r=0.591,P=0.022;r=0.452,P=0.027),DNA错配修复蛋白与病理分期﹑淋巴结转移呈负相关(r=-0.487,P=0.041;r=-0.551,P=0.030)。不同CD44、甲基化Sept9基因、PLCEl及DNA错配修复蛋白表达情况的结直肠癌患者3年生存率差异有统计学意义(P<0.05)。PLCEl、DNA错配修复蛋白与结直肠癌患者3年生存率呈正相关(r=0.574,P=0.041;r=0.478,P=0.037),甲基化Sept9基因与结直肠癌患者3年生存率呈负相关(r=-0.515,P=0.034)。结论CD44、PLCEl、甲基化Sept9基因及DNA错配修复蛋白均与结直肠癌的病理分期相关,其检测有助于了解疾病的恶性程度,评估患者预后。

Objective To investigate the correlation of the expressions of cluster of differentiation 44( CD44),phospho lipase Cεl( PLCEl),methylated Sept9 gene and DNA mismatch repair protein in cancer tissues and peripheral blood with the pathological stage and prognosis of colorectal cancer. Methods 56 patients diagnosed with colorectal cancer in the Second People’s Hospital of Xining from Mar. 2013 to May. 2015 were defined as the observation group,and 55 healthy individuals who had physical examination in our hospital were defined as the control group during the same period. The expressions of methylated Sept9 gene,CD44,PLCEl and DNA mismatch repair proteins were compared between the two groups. The clinical distribution of above indexes in patients with colorectal cancer was analyzed.The prognosis of colorectal cancer patients with different expressions of methylated Sept9 gene,CD44,PLCEl and DNA mismatch repair protein was compared and the correlation test was performed.Results The positive rates of methylated Sept9 gene and CD44,the negative rate of PLCEl and the deletion rate of DNA mismatch repair protein expression in the observation group were higher than those in the control group( P<0.05). The expressions of methylated Sept9 gene,PLCEl and DNA mismatch repair protein in tumor invasion depth,tumor size,pathological stage and lymph node metastasis were significantly different in colorectal cancer patients( P < 0. 05). The expressions of CD44 in tumor invasion depth,pathological stage and lymph node metastasis were significantly different in colorectal cancer patients( P<0.05).PLCEl was negatively correlated with depth of invasion and pathological stage in colorectal cancer( r =-0. 367,P =0.045;r =-0.522,P = 0. 008). Methylated Sept9 gene was positively correlated with depth of invasion,pathological stage and lymph node metastasis( r = 0.715,P = 0.026;r = 0.471,P = 0.032;r = 0.453,P = 0.010). CD44 was positively correlated with depth of invasion,pathological stage and lymph node metastasis( r = 0.349,P = 0.007;r = 0.591,P =0.022;r = 0.452,P = 0.027). DNA mismatch repair protein was negatively correlated with pathological stage and lymph node metastasis( r =-0.487,P = 0.041;r =-0.551,P = 0.030). The 3-year survival rate of colorectal cancer patients with different expressions of CD44,methylated Sept9 gene,PLCEl,DNA mismatch repair protein was different( P<0.05). PLCEl,DNA mismatch repair protein were positively related with 3-year survival rate in colorectal cancer patients( r=0.574,P=0.041;r=0.478,P=0.037). Methylated Sept9 gene was negatively correlated with 3-year survival rate in colorectal cancer patients( r =-0.515,P = 0.034). Conclusion CD44,PLCEl,methylation Sept9 gene and DNA mismatch repair protein are correlated with the pathological stage of colorectal cancer. The detection of them is helpful to understand the malignancy of the disease and to evaluate the prognosis of patients.