MTS1/p16基因失活与大肠癌发生及患者生活质量的关系(英文)

Effect of the gene MTS1/p16 inactivation on the carcinogenesis of the large intestine and the patient's life quality

背景:本实验应用免疫组化及粘液组化方法观察MTS1/p16基因产物在大肠癌组织的表达情况,并与癌旁移行黏膜及正常黏膜进行了对比,了解患者的预后与生活质量。目的:探讨MTS1/p16基因失活与大肠癌发生的关系及对患者生活质量的意义。设计:标准对照的实验研究。地点和对象:地点为中国医科大学附属第二医院外科,对象为2000-01/2001-02住院大肠癌手术患者。男67例,女43例,年龄40～83岁。病程1个月～1.5年,选取患者大肠癌及癌旁组织新鲜标本。方法:应用免疫组化方法观察MTS1/P16基因产物在110例大肠癌组织的表达情况,并与非典型增生、癌旁移行粘膜及正常粘膜进行了比较。主要观察指标:以细胞呈清晰棕色为阳性判断标准,按阳性细胞所占的比例分为:+,阳性细胞数<25%;,阳性细胞数25%～50%;,阳性细胞数>50%。以细胞无棕色或与背景一致的淡棕色为阴性。生活质量测定采用李凌江等编制的生活质量综合评定问卷。结果:癌组织p16阳性分级表达低于正常黏膜及移行黏膜(P<0.05)。在管状腺癌中,高分化22例,p16阳性率86%;中分化43例,p16阳性率33%;低分化7例,p16阳性率29%,高低分化癌之间差异有显著意义(t=5.1,P<0.01)。结论:p16蛋白的表达缺失与大肠癌的发生有关,并随着分化程度下降p16表达缺失增加。

BACKGROUND:The present experiment aimed at ob se rving the expression of the products of the gene MTS1/p16i n the tissues of the carcinoma of larg e intestine,using immunohistochemi cal and mucin histoch emical methods and compared with,transitional mucosa and the normal mucosa so a s to learn about the patient ' s prognosis and life quality.OBJECTIVE:To explo re the relationship between the inaction of the gene MTS1/p16and the carcino genesis of l arge intestine,and patients' life quality.DESIGN:Standard contro lled trial.SETTING AND PARTICIPANTS:The experiment was carried out at the Labo ratory for the Division of the Surgery of the Second Affiliated Hospi tal of Chi na Medical University.The subje cts,67males and 43females,aged fro m40t o 83years old(mean age 53±15.3),were the inpatients that were hospit alized from 2000/01to 2001/02.They suffered from the carcinoma o f large intestine.The course of disease was 1month to 1.5years.The fresh s pecimen from the carcinoma of large intestines and the para-cancerous t is-sue s of the patients were taken.INTERVENTIONS:The expression of the gene products o f MTS1/p16in110cases of carcinoma of large intestines was observed by immunohisto-chemical method,and was compared wi th that in atypical dysplasia ,and th e transitional mucosa and the normal m ucosa.MAIN OUTCOME MEASURES:Wh en the cell appears clear brown,it is positive,and it is taken as the stand ar d for judging if a cell is positive.Then,when the cell doesn' t show brown,or light brown that is th e same as the background,it is negative,and it is take n as the standard for judging if a a cell is negative.According to the nu mber of the positive cells,they can b e divided into the following:+:the positiv e cells <25%,;++:the pos-itive cells,25%(50%;+++:the posi tive cells >50%.The determi-nation of life quality was decided ac cording to the Comprehensive Evaluation Questionnaire for Life Quality by Li ng-Jiang L i.RESULTS:The grading positive expression of p16in cancerous tissues was low er than that in normal mucosa and t ransitional mucosa(P<0.05).In tubula r adenocarcinoma,22cases belonged to the group of high different ia-tion,an d the positive rat was 86%;43cases to the group of medium dif-ferentiatio n,and the positive rate was 33%;7cases to the group of low differentiation ,and the positive r ate was 29%.The difference between h igh and low differ entiation of cancer wa s significant (t=5.1,P<0.01).Th e inactivation of p16gene express ion is related to the carcinogenesis of larg e intestines,and with the lowering of differentiation,the inactivation of p1 6expression was i ncreased.This index plays an important role in judging the sta