结肠腺瘤性息肉、结肠癌患者P-STAT3表达及其与Hp感染的关系

P-STAT3 expression and its relationship with Hp infection in patients with colon adenomatous polyps and colon cancer

目的观察酪氨酸磷酸化的信号传导及转录活化因子3(P-STAT3)在结肠腺瘤性息肉、结肠癌组织中的表达及幽门螺杆菌(Hp)感染与P-STAT3表达关系。方法选取2019年11月~2022年12月秦皇岛港口医院行病理活检获得的结肠腺瘤性息肉74例(腺瘤性息肉组)、结肠癌标本67例(肠癌组)及同期行结肠镜检查阴性标本50例(健康对照组)。免疫组织化学法染色,采用快速尿素酶试验或13 C-尿素呼气试验进行Hp检测。比较3组标本P-STAT3表达阳性率及Hp阳性率,分析Hp感染与腺瘤性息肉特点、肠癌病理参数间的关系。结果健康对照组、腺瘤性息肉组、肠癌组Hp感染率分别为24.0%(1250)、68.92%(5174)、59.70%(4067),腺瘤性息肉组和肠癌组感染率高于健康对照组,组间差异均有统计学意义(χ^(2)=24.088、17.780,P<0.05);息肉组与肠癌组感染率差异无统计学意义(χ^(2)=1.305,P>0.05)。息肉组Hp感染阳性患者1 cm以上息肉和进展期腺瘤占比均高于Hp阴性患者,组间差异有统计学意义(χ^(2)=3.844、4.610,P<0.05)。两亚组间性别、年龄、息肉数量、部位差异无统计学意义(P>0.05)。Hp感染与未感染的结肠癌患者性别、年龄、肿瘤分化程度、最大径、侵及浆膜及淋巴转移比较,差异无统计学意义(P>0.05)。在健康对照组、腺瘤性息肉组、肠癌组P-STAT3阳性表达率分别为8.0%(450)、47.29%(3574)、85.08%(5767),3组P-STAT3表达逐步升高,组间两两比较,差异均有统计学意义(P<0.05)。腺瘤性息肉组和肠癌组Hp感染与P-STAS3表达均呈正相关(r=0.314、0.193,P<0.05)。结论幽门螺杆菌感染可能增加结肠腺瘤、结肠癌的发病率,其可能通过P-STAT3通路在结肠癌发生发展过程中发挥作用。对于Hp感染者应加强结肠镜筛查,早期干预。

Objective To observe the expression of tyrosine phosphorylation signaling and activators of transcription 3(P-STAT3)in colon adenomatous polyps and colon cancer tissues,and the relationship between Helicobacter pylori(Hp)infection and P-STAT3 expression.Methods 74 cases of colon adenomatous polyps admitted to our hospital from November 2019 to December 2022,67 cases of colon cancer specimens,and 50 cases of negative patients undergoing colonoscopy were collected.Immunohistochemical staining,rapid urease test or 13C urea breath test for Hp detection.Compare the positive rates of p-STAT3 expression and Hp expression in three groups,and analyze the relationship between Hp infection,characteristics of adenomatous polyps,and pathological parameters of colorectal cancer.Results The infection rates of Hp in the normal control group,adenomatous polyp group,and colon cancer group were 24.0%(1250),68.92%(5174),and 59.70%(4067),respectively.The infection rates in the adenomatous polyp group and colon cancer group were higher than those in the normal group,and the differences between the groups were statistically significant(χ^(2)=24.088,17.780,P<0.05).There was no statistically significant difference in the infection rates between the polyp group and the colon cancer group(χ^(2)=1.305,P>0.05).The proportion of polyps above 1 cm and advanced adenomas in patients with positive Hp infection in the polyp group was higher than that in patients with negative Hp infection.The difference between the groups was statistically significant(χ^(2)=3.844,4.610,P<0.05).There was no statistically significant difference in gender,age,number of polyps,or location between the two subgroups(P>0.05).There was no statistically significant difference in gender,age,tumor differentiation,maximum diameter,invasion of serosa and lymph node metastasis between Hp infected and uninfected colon cancer patients(P>0.05).The positive expression rates of P-STAT3 in the normal control group,adenomatous polyp group,and colon cancer group were 8.0%(450),47.29%(3574),and 85.08%(5767),respectively.The expression of P-STAT3 gradually increased in the three groups,and the differences between the two groups were statistically significant(P<0.05).There was a positive correlation between Hp infection and P-STAS3 expression in the adenomatous polyps group and the colon cancer group(r=0.314,0.193,P<0.05).Conclusion Helicobacter pylori infection may increase the incidence rate of colon adenoma and colon cancer,which may play a role in the development of colon cancer through P-STAT3 pathway.Colonoscopy screening and early intervention should be strengthened for Hp infected individuals.