艰难梭菌感染对大肠癌癌组织中SOX2与CDX2及HNF4α表达的影响

Effect of Clostridium difficile infection on the expression of SOX2,CDX2 and HNF4αin colorectal cancer tissues

目的探讨艰难梭菌感染对大肠癌癌组织中性别决定区Y框蛋白2(SOX2)、尾型同源框转录因子2(CDX2)、肝细胞核因子4α(HNF4α)表达水平的影响。方法选取2018年9月-2020年9月延边大学附属医院(延边医院)收治的258例大肠癌患者(大肠癌组)、103例大肠腺瘤患者(大肠腺瘤组)以及150名无胃肠道病史的中老年健康人群(健康对照组)。采集粪便标本进行艰难梭菌培养与鉴定,比较三组的艰难梭菌感染率。采集大肠癌组手术切除的癌组织、大肠腺瘤组结肠镜活检的肠腺瘤组织、健康对照组结肠镜活检的正常肠黏膜组织,进行免疫组化染色,比较三组的SOX2、CDX2、HNF4α阳性表达率。结果大肠癌组艰难梭菌感染率为13.18%,高于大肠腺瘤组3.88%与健康对照组0(P<0.05)。大肠癌组中SOX2阳性表达率为62.40%,高于大肠腺瘤组19.42%与健康对照组0(P<0.05)。大肠癌组中CDX2、HNF4α阳性表达率为32.95%和35.27%,低于大肠腺瘤组81.55%和67.96%、健康对照组93.33%和88.67%(P<0.05)。艰难梭菌感染与大肠癌癌组织SOX2阳性表达呈正相关(c=0.362,P<0.05)。艰难梭菌感染与大肠癌癌组织CDX2、HNF4α阳性表达呈负相关(c=-0.441,c=-0.398,P<0.05)。SOX2阳性表达、CDX2阳性表达、HNF4α阳性表达与感染艰难梭菌有相关性(P<0.05)。结论艰难梭菌感染与大肠癌的发生密切相关,机制可能是艰难梭菌影响SOX2、CDX2、HNF4α的表达。

OBJECTIVE To investigate the effect of Clostridium difficile infection on the expression levels of sex determining region Y box protein 2(SOX2),caudal type homeobox transcription factor 2(CDX2)and hepatocyte nuclear factor 4α(HNF4α)in colorectal cancer tissues.METHODS From Sep 2018 to Sep 2020,258 patients with colorectal cancer in the colorectal cancer group,103 patients with colorectal adenoma in the colorectal adenoma group,and 150 middle-aged and elderly healthy people without history of gastrointestinal diseases in the healthy control group were enrolled in this study.Stool specimens were collected for C.difficile culture and identification,and the infection rates of C.difficile in the 3 groups were compared.The surgically resected cancer tissues in the colorectal cancer group,intestinal adenoma tissues collected during colonoscopic biopsy in the colorectal adenoma group,and normal intestinal mucosa tissues collected during colonoscopic biopsy in the healthy control group were used for immunohistochemical staining.The positive expression rates of SOX2,CDX2,and HNF4αin the 3 groups were compared.RESULTS The C.difficile infection rate in the colorectal cancer group was 13.18%,significantly higher than 3.88%in the colorectal adenoma group and 0%in the healthy control group(P<0.05).The positive expression rate of SOX2 in the colorectal cancer group was 62.40%,significantly higher than 19.42%in the colorectal adenoma group and 0%in the healthy control group(P<0.05).The positive expression rates of CDX2 and HNF4αin the colorectal cancer group were 32.95%and 35.27%,significantly lower than 81.55%and 67.96%in the colorectal adenoma group,as well as 93.33%and 88.67%in the healthy control group(P<0.05).C.difficile infection was positively correlated with the positive expression of SOX2 in colorectal cancer tissues(c=0.362,P<0.05),but was negatively correlated with the positive expression of CDX2 and HNF4αin colorectal cancer tissues(c=-0.441,c=-0.398,P<0.05).Positive expression of SOX2,CDX2 and HNF4αwere associated with infection with C.difficile(P<0.05).CONCLUSION C.difficile infection is closely related to the occurrence of colorectal cancer,which may be the result of the positive expression of SOX2,CDX2 and HNF4αinduced by C.difficile.