目的 肿瘤的进展是一个多因素参与、相互影响的复杂病理生理过程,本研究意在探讨上皮-间质转化(EMT)标志物E-钙黏蛋白(E-cadherin)和波形蛋白(Vimentin)的表达情况与结肠癌相关临床病理因素的关联性,并分析其对患者预后的影响.方法 收集2009-01-01-2014-01-01于新疆医科大学附属肿瘤医院胃肠外科行结肠癌根治术且术后病理检查明确诊断的116例TNM分期Ⅲ期患者结肠癌组织及其癌旁组织标本.应用免疫组织化学SP法检测结肠癌组织中E-cadherin、Vimentin的表达情况,采取门诊或病房复查、电话等相结合的方式进行随访,随访截止时间为2015-01-01.116例结肠癌术后患者中107例获得随访,随访时间为4.1~63.0个月,随访率为92.2%(107/116),中位随访时间为46.0个月;记录患者累积生存率(OS)及无病生存率(DFS).采用多因素Logistic回归分析分析E-cadherin、Vimentin表达情况与临床病理因素的关联性;采用Kaplan-Meier法绘制生存曲线,生存分析采用Log-rank检验. 结果 116例患者结肠癌组织中E-cadherin和Vimentin的阳性表达率分别为79.3%(92/116)、15.5%(18/116).癌胚抗原(CEA)、肿瘤直径、脉管侵犯情况、分化程度、淋巴结转移情况的E-cadherin阳性表达率比较,差异有统计学意义(P<0.05).肿瘤直径、脉管侵犯情况、神经侵犯情况、分化程度、淋巴结转移情况的Vimentin阳性表达率比较,差异有统计学意义(P<0.05).多因素Logistic回归分析结果显示,CEA、脉管侵犯情况、分化程度与E-cadherin的表达情况存在关联性(P<0.05);脉管侵犯情况、神经侵犯情况、分化程度与Vimentin的表达情况存在关联性(P<0.05).E-cadherin阳性表达患者OS及DFS高于E-cadherin阴性表达患者(P<0.05);Vimentin阳性表达患者的OS及DFS低于Vimentin阴性表达患者(P<0.05). 结论 CEA、脉管侵犯情况、分化程度与E-cadherin表达情况存在关联性,脉管侵犯情况、神经侵犯情况、分化程度与Vimentin表达情况存在关联性;E-cadherin、 Vimentin是判断结肠癌患者预后的重要指标.%Objective The development of tumor is a complex pathophysiological process involving many interrelated factors.The purpose of this study was to investigate the correlation of the expressions of epithelial mesenchymal transition(EMT) markers(E-cadherin and Vimentin) with the clinicopathological factors and prognosis of colon cancer.Methods Immunohistochemistry with SP method was performed to detect the expressions of E-cadherin and Vimentin in the colon cancer and adjacent tissue specimens taken from 116 stage Ⅲ colon cancer patients who underwent radical resection of colon cancer in Department of Gastrointestinal Surgery of Affiliated Tumor Hospital of Xinjiang Medical University from January 1,2009 to January 1,2014 and pathologically diagnosed as colon cancer postoperatively.The patients were followed up by outpatient or ward review,telephone and so on with a deadline of January 1st 2015.Totaled 92.2% of the participants(107/116) were followed up for 4.1-63.0 months with a median follow-up of 46.0 months.Overall survival(OS) and disease-free survival(DFS) of patients were recored.Multivariate Logistic regression analysis was performed to investigate the correlation of the expressions of E-cadherin and Vimentin with the clinicopathological factors of colon cancer.Kaplan-Meier survival analysis was conducted to estimate the survival function.Survival rate was compared with the Log-rank test.Results The positive rate of E-cadherin and Vimentin expressions in all the participants was 79.3%(92/116),15.5%(18/116),respectively.The positive rates of E-cadherin of carcinoembryonic antigen(CEA),tumor diameter,vascular invasion,differentiation degree of colon cancer cells,lymphatic metastasis showed significant differences(P<0.05).The positive rates of Vimentin of tumor diameter,vascular invasion,perineural invasion,differentiation degree of colon cancer cells,lymphatic metastasis showed significant differences(P<0.05).Multivariate Logistic regression analysis found that CEA,vascular invasion and differentiation degree of colon cancer cells were significantly associated with the expression of E-cadherin(P<0.05).Vascular invasion,nerve invasion and differentiation degree of colon cancer cells were significantly associated with the expression of vimentin(P<0.05).Notable differences were found in the cumulative OS and DFS between E-cadherin positive group and negative group(P<0.05).The cumulative OS and DFS differed significantly between Vimentin positive group and negative group(P<0.05).Conclusion CEA,vascular invasion and the differentiation degree of colon cancer cells are the associated factors for the expression of E-cadherin.Vascular invasion,nerve invasion and the differentiation degree of colon cancer cells are the associated factors for the expression of Vimentin.E-cadherin and Vimentin are important adverse prognostic factors in colon cancer.
展开▼
