大肠癌唾液酸化Lewis X表达的临床意义

Expression of sialyl Lewis X in colorectal carcinoma and clinical significance

目的 :探讨大肠癌组织中细胞粘附分子唾液酸化LewisX表达状况与肿瘤发生、分化、转移及预后的关系。方法 :应用免疫组织化学催化信号放大法 (catalyzedsignalamplification ,CSA)和计算机图像分析技术 ,对 90例大肠癌原发癌灶、距肿瘤边缘 2cm的癌旁粘膜组织、远离癌组织 10cm以上的非癌大肠粘膜以及 5 1例转移淋巴结进行唾液酸化LewisX表达和反应强度进行比较 ,并对其中 5 3例患者进行随访。结果 :唾液酸化LewisX阳性物质在远离癌组织的非癌大肠粘膜中阳性率为 16 .7% (15 / 90 ) ,主要位于腺腔缘游离面 ;癌旁粘膜组织阳性率为 83.3% (75 / 90 ) ,主要位于细胞浆和 /或腺腔缘游离面 ;大肠癌组织中唾液酸化LewisX阳性表达率为 94 .4 % (85 / 90 ) ,主要分布于癌组织腺管细胞膜、细胞浆以及粘液腺癌的粘液湖内。转移淋巴结中唾液酸化LewisX阳性率为 96 .1% (49/ 5 1)。图像分析 :唾液酸化LewisX阳性细胞平均积分光密度值在低分化腺癌中显著高于高、中分化腺癌和粘液癌 (P <0 .0 1) ;有淋巴结转移者显著高于无淋巴结转移者 (P <0 .0 1) ;5年内死亡病例显著高于生存病例 (P <0 .0 1)。结论 :唾液酸化LewisX表达阳性率和反应强度对反映大肠癌组织发生发展、判断恶性程度、预测转移和评估患者预后具有重要意?

ObjectiveTo investigate the level of cell adhesion molecule sialy1 Lewis X expression in colorectal carcinoma and its relationship with carcinogenesis,differentiation,metastasis and prognosis.Methods: Sialyl Lewis X expression and its optical density in colorectal carcinoma (n=90),mucosa adjacent to the carcinoma,remote normal mucosa and metastatic lymphatic nodes was comprehesively studied with catalyzed signal amplification method combined with image analysis technique.Fifty-three patients were followed up.Results:The weaker staining in remote normal colorectal mucosa was observed in very limited parts of some crypts.Positive rate of sialyl Lewis X expression was only 16.7%.The stronger staining in mucosa adjacent to the carcinoma was observed in cytoplasma and parts of some crypts.Positive rate of sialy1 Lewis X expression was 83.3%.The positive expression of sialyl Lewis X was observed in 85 of 90 patients with colorectal carcinoma (94.4%).The cellular membrane and cytoplasma of cancer tubules and the mucous pool of the mucinous adenocarcinoma were strongly stained.Positive rate of sialyl Lewis X expression was 96.1% in metastatic lymphatic nodes.The mean integral optical density of sialyl Lewis X positive cell in poorly differentiated adenocarcinoma was significantly higher than that in differentiated and mucinous ones (P<0.01) . It was obviously higher in patients with positive lymphatic nodes than that in negative ones (P<0.01). With followed-up for longer than 5 years,it was much lower in the alive cases than that in the death (P<0.01). Conclusion: These findings indicate that changes of sialyl Lewis X expression and its optical density are related to carcinogenesis,differentiation,invasion and metastasis of colorectal carcinoma.It may play an important role to predict the prognosis of patients with colorectal carcinoma.