中国人结肠癌nm23H_1基因遗传不稳定性的研究

GENETIC INSTABILITY OF GENE nm23H_1 IN COLON CANCER OF CHINESE PATIENT

采用石蜡包埋组织抽提DNA、PCR-单链构象多态性(SSCP)、常规银染、Envision免疫组织化学和Leica-Qwin计算机图像分析等方法,研究中国人17号染色体D17S396位点微卫星不稳定性和杂合性缺失,对nm23H_1基因表达的影响,阐明nm23H_1基因遗传不稳定性与结肠癌进展的关系,为临床治疗提供实验依据。实验中,30例结肠癌D17S396位点MSI、LOH检出率和nm23H_1蛋白阳性率分别为26.67%、20.00%和53.33%。在肿瘤TNM分期中,Ⅰ+Ⅱ期的MSI检出率和nm23H_1蛋白阳性率分别为43.75%和81.25%,高于Ⅲ+Ⅳ期的7.14%(MSI,p<0.05)和21.43%(nm23H_1,p<0.01)。而LOH检出率在Ⅲ+Ⅳ期35.71%高于Ⅰ+Ⅱ期6.25%(p<0.05)。随着结肠癌病理Duke’s分期的升高,LOH检出率呈现增加趋势。nm23H_1蛋白阳性率在管状腺癌组为60.00%,明显高于粘液腺癌组的20.00%(p<0.01)。随着管状腺癌分化程度的升高,其阳性率呈增高趋势。此外,nm23H_1蛋白阳性率在MSI阳性组为75%,也高于MSI阴性组的45.45%(p<0.05)。计算机图像定量分析显示,nm23H_1蛋白在各临床病理参数影响下的表达强度没有差异。实验结果提示MSI和LOH通过相互独立的途径调控散发性结肠癌的进展。LOH多发生于散发性结肠癌的晚期阶段并赋予散发性结肠癌细胞高侵袭、低预后的表型。相反,MSI是散发性结肠癌的早期分子标志,提高结肠癌局部nm23H_1蛋白表达量可有效抑制结肠癌转移并改善散发性结肠癌患者预后。

Techniques such as DNA extraction from paraffin-embedded tissues, polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP), ordinary silver stain, Envision im-munohistochemistry and Leica-Qwin computer imaging techniques were used to study microsatellite instability (MSI) and loss of heterozygosity (LOH) of locus D17S396 at the 17th chromosome of Chinese patients and their influence on the expression of gene nm23H1, and to clarify the relationship between the genetic instability of gene nm23H1 and the development of colon cancer, which may provide experimental basis for clinical treatment. In our experiments, the frequency of MSI, LOH and nm23H1 protein reacted positive of 30 cases of colon cancer were 26.67% , 20.00% and 53. 33% respectively. In tumor node metastasis (TNM) staging, the positive frequency of MSI (43. 75%) and nm23H1 protein (81. 25%) in stage Ⅰ+ Ⅱ were more than those (MSI 7. 14% , p<0. 05 and nm23H1 21.43 % , p < 0.01) in stage Ⅲ + Ⅳ , while the frequency of LOH (35.71%) , which had a rising trend along with the Duke' s staging increasing, was higher than that of LOH (6. 25% , p < 0.05) in stage Ⅰ + Ⅱ . The positive frequency of nm23H1 protein in the group of tubular adenocarci-noma (60.00% ) was distinctively higher than that in the group of mucoid adenocarcinoma (20. 00% , p<0.01), showing a rising trend along with the increase of the differentiation degree of tubular adenocarcinoma. Furthermore, the positive frequency of nm23H1 protein in MSI positive group was also higher than MSI negative group (p<0.05). And there was no difference in nm23H1 protein expression analyzed by computer imaging techniques. The results of experiments indicated that both MSI and LOH controlled the development of sporadic colon cancer independently in different paths. LOH occurred mostly in the late period of sporadic colon cancer and endowed with it a high aggressive and poor prognosis. In contrast, MSI was an early period molecule marker of sporadic colon cancer Increasing the amount of nm23H1 protein expression could effectively restrain colon cancer metastasis and improved prognosis of sporadic colon cancer patients.