目的：分析新疆维吾尔族、汉族散发性结直肠癌( sporadic colorectal carcinoma, SCC)中hMLH-1、hMSH-2的表达及其与临床病理特征的关系。方法采用免疫组化法检测60例维吾尔族、196例汉族SCC标本及60例维吾尔族、汉族正常结直肠( normal colorectal mucosa, NCM)标本中hMLH-1、hMSH-2的表达。结果新疆维吾尔族、汉族NCM中hMLH-1、hMSH-2阳性率均为100%(60/60)。维吾尔族SCC中hMLH-1阳性率(75%,45/60)明显低于汉族(93．4%,183/196)(P<0．05)；维吾尔族SCC中hMSH-2阳性率(91．7%,55/60)与汉族(94．4%,185/196)相比差异无统计学意义(P>0．05)。维吾尔族SCC平均发病年龄(57．63岁)低于汉族(65．64岁)(P<0．05),且维吾尔族≤40岁(28．3%,17/60)SCC患者高于汉族(3．6%,7/196)。维吾尔族、汉族管状腺瘤( tubular adenoma, TA)中hMLH-1、hMSH-2阳性率均为100%。维吾尔族管状绒毛状腺瘤( tubulovil-lous adenoma, TVA)中hMLH-1、hMSH-2阳性率均为66．7%(2/3)；汉族TVA中hMLH-1、hMSH-2阳性率分别为74．2%(23/31)、90．3%(28/31),两组人群TA组与TVA组相比差异有显著性(P<0．05)。维吾尔族、汉族SCC不同年龄组中hMLH-1、hMSH-2阳性率差异有显著性(P<0．05)。汉族SCC中hMLH-1、hMSH-2表达呈正相关(rs =0．737,P<0．05)；维吾尔族SCC中hMLH-1、hMSH-2表达亦呈正相关(rs =0．383,P<0．05)。结论与新疆维吾尔族、汉族SCC中均存在hMLH-1、hMSH-2表达缺失,且与年龄与腺瘤密切相关。维吾尔族SCC患者平均发病年龄低于汉族,且hMLH-1阳性率低于汉族。联合检测hM-LH-1、hMSH-2有利于为不同民族的结直肠癌预防重点和个性化治疗方案选择提供理论基础。%Purpose To detect the incidence rate, average age and the expression of hMLH-1 and hMSH-2 of sporadic colorectal carci-noma ( SCC) with Han and Uygur patients. Methods The expression of hMLH-1 and hMSH-2 was detected in SCC for 60 cases of Uygur and 196 cases of Han by immunohistochemical method, including 60 Uygur and Han cases normal colorectal mucosa ( NCM) . Results The positive rate of hMLH-1 and hMSH-2 proteins expression in the NCM was 100%. There was a marked difference in the positive rate of hMLH-1 in SCC between Han (93. 4%, 183/196)and Uygur (75%, 45/60) (P<0. 05). There was no significance in the positive rate of hMSH-2 in NCM between Han (94. 4%, 185/196) and Uygur (91. 7%, 55/60) (P>0. 05). The average age of Han and Uygur SCC patients were 65. 64 years, 57. 63 years, respectively, and Uygur SCC cases were more likely to be diagnosed at less 40 years old (P<0. 05). The positive rate of hMLH-1 and hMSH-2 expression in the tubular adenoma was 100%. The positive rate of hMLH-1 and hMSH-2 expression in the tubulovillous adenoma in Uygur and Han were 66. 7%( 2/3 ) and 66. 7%( 2/3 ) , and 74. 2%(23/31) and 90. 3%(28/31), respectively, significantly lower than those of tubular adenoma (P<0. 05). The expression of hMLH-1 was positively correlated with that of hMSH-2 in SCC in Han(rs =0. 737, P<0. 05). The expression of hMLH-1 was positive-ly correlated with that of hMSH-2 in SCC in Uygur(rs =0. 383, P<0. 05). There exists marked difference in the positive rate of hM-LH-1 and hMSH-2 among difference age groups (P<0. 05). Conclusion There is a certain loss of hMLH-1 and hMSH-2 expression in SCC in Han and Uygur Chinese, which is related to adenoma and age. The expression of hMLH-1 in SCC tissue among Uygur pa-tients is not resemble to those of Han patients. The average age of Uygur SCC patients is younger than Han, and the positive rate of hMLH-1 is higher. Combined detection of hMLH-1 and hMSH-2 proteins may be used for judging the severity and prognosis of SCC in Xinjiang, which helps improve patients’ treatment program and rationalize their choices.
展开▼
