结肠腺癌组织中畸胎瘤衍生生长因子-1、锌指转录因子与基质金属蛋白酶-9的表达及临床意义

Expression and clinicopathological significance of Cripto-1,Snail and MMP-9 in colon adenocarcinoma

目的研究结肠腺癌组织中畸胎瘤衍生生长因子-1(Cripto-1)、锌指转录因子(Snail)和基质金属蛋白酶-9(MMP-9)的表达情况及临床病理特征。方法回顾性分析2020年1月至2021年8月于韶关市粤北人民医院胃肠外科92例行手术切除结肠腺癌患者的临床资料,手术切除标本92个。另选取癌旁不典型增生组织56例和正常结肠组织35例作为对照。采用免疫组化检测并比较Cripto-1、Snail和MMP-9在结肠腺癌组织、不典型增生和正常结肠黏膜组织中的表达情况,采用Spearman相关分析Cripto-1、Snail和MMP-9与结肠腺癌临床病理特征的相关性。结果结肠腺癌、不典型增生、正常结肠组织的CR-1、Snail和MMP-9阳性率比较差异有统计学意义(P<0.05);结肠腺癌及不典型增生组织中CR-1、Snail和MMP-9阳性率均高于正常结肠组织,结肠腺癌组织中Snail和MMP-9阳性率均高于不典型增生组织,差异均有统计学意义(P<0.05);结肠腺癌组织与不典型增生组织中CR-1阳性率比较差异无统计学意义。肿瘤的浸润深度、临床TNM分期及淋巴结转移情况不同的患者Cripto-1、Snail和MMP-9在结肠腺癌组织中的表达阳性率比较差异有统计学意义(P<0.05)。肿瘤浸润T3~T4、临床分期Ⅲ~Ⅳ期、有淋巴结转移的患者结肠腺癌组织中CR-l、Snail和MMP-9的表达阳性率均高于肿瘤浸润T1~T2、临床分期Ⅰ~Ⅱ期和无淋巴结转移的患者,差异有统计学意义(P<0.05)。结肠腺癌组织中CR-1表达与Snail和MMP-9的表达呈正相关(r>0,P<0.05),MMP-9表达与Snail表达亦呈正相关(r>0,P<0.05)。结论Cripto-1、Snail和MMP-9在结肠癌的浸润和转移中起协同调节作用。

Objective To study the expression and clinical pathological characteristics of Cripto-l,Snail and matrix metalloproteinase-9(MMP-9)in colon adenocarcinoma tissues.Methods Clinical datas of 92 patients with colorectal adenocarcinoma who underwent surgical resection from January 2020 to August 2021 in the Department of Gastrointestinal Surgery of North Guangdong People's Hospital of Shaoguan City were retrospectively analyzed,92 specimens were surgically resected.In addition,56 cases of paracancer atypical hyperplasia and 35 cases of normal colon tissue were selected as controls.The expression of Cripto-1,Snail and MMP-9 were detected and compared by immunohistochemical method among colorectal adenocarcinoma tissues,atypical hyperplasia and normal colon tissues,and the correlation Cripto-1,Snail and MMP-9 with the clinical pathological characteristics of colon adenocarcinoma were analysed by spearman correlation analysis.Results There were significant differences in positive rates of CR-1,Snail and MMP-9 among colon adenocarcinoma,atypical hyperplasia and normal colon tissue(P<0.05),the positive rates of CR-1,Snail and MMP-9 in colon adenocarcinoma and atypical hyperplasia tissues were higher than those in normal colon tissues,the positive rates of Snail and MMP-9 in colon adenocarcinoma tissues were higher than those in atypical hyperplasia tissues,and the differences are statistically significant(P<0.05);there were no significant differences in positive rates of CR-1 between colon adenocarcinoma tissues and atypical hyperplasia tissues.There were significant differences in positive expression rates of Cripto-1,Snail and MMP-9 in colorectal adenocarcinoma tissues of patients with different tumor invasion depth,clinical TNM stage and lymph node metastasis(P<0.05).The positive rates of CR-l,Snail and MMP-9 expression in colon adenocarcinoma tissues of patients with tumor infiltration T3-T4,clinical stageⅢ-Ⅳand lymph node metastasis were higher than those in patients with tumor infiltration T1-T2,clinical stageⅠ-Ⅱand no lymph node metastasis,and the differences were satistically significant(P<0.05).CR-1 expression in colon adenocarcinoma tissues was positively correlated with Snail and MMP-9 expression(r>0,P<0.05),and MMP-9 expression was also positively correlated with Snail expression(r>0,P<0.05).Conclusion Expressions of Cripto-1,Snail and MMP-9 may play a synergistic regulatory role in the invasion and metastasis of colon adenocarcinoma.