结直肠癌及癌前病变hTERT mRNA定量检测及其临床意义

摘要

Objective To investigate clinical significance of quantitative detection of human telomerase reverse tran-scriptase ( hTERT) mRNA in colorectal cancer and its precancerous lesions. Methods The quantitative expression of hTERT mRNA in tissues were detected by real-time fluorescence quantitative-PCR of colorectal cancers ( n=95 ) , color-ectal adenomatous polyposis ( n=50 ) , colorectal hyperplastic polyposis ( n=25 ) , ulcerative colitis ( n=21 ) and nor-mal control ( n=20 ) . The relationship between the quantitative expression of hTERT mRNA in colorectal cancer tissues and the pathologic features and prognosis were analyzed. Results The level of hTERT mRNA expression in the colorec-tal cancer group was significantly higher than those in colorectal adenomatous polyposis group, colorectal hyperplastic polyposis group, ulcerative colitis group and normal control group (P<0. 05). The level of hTERT mRNA expression in adenomatous polyposis with high grade intraepithelial neoplasia was significantly higher than that in adenomatous polypo-sis with low grade intraepithelial neoplasia ( P<0 . 01 ) , which were both significantly higher than those in denomatous polyposis with no intraepithelial neoplasia ( P<0 . 05 ) . The level of hTERT mRNA expression in ulcerative colitis group was significantly higher than in normal control ( P<0 . 05 ) . The level of hTERT mRNA expression in colorectal cancer group was positively related with the differentiated degree of tumor, depth of invasion, lymph node metastasis, TNM sta-ges and the postoperative recurrence ( P <0 . 05 ) , and negatively related with the postoperative survival time ( P <0 . 05 ) . Multivariate Cox regression analysis showed that the level of hTERT mRNA expression in tissues was independ-ent prognostic factor for colorectal cancer. Conclusion The level of hTERT mRNA expression in colorectal cancer tis-sues is relative with the important pathologic features, and can be a valuable clinical factor for evaluation of postoperative prognosis. The increase expression of hTERT mRNA in colorectal adenomatous polyposis and ulcerative colitis tissues may be a predictor of colorectal tumorigenesis.%目的：探讨结直肠癌及癌前病变组织中人端粒酶逆转录酶( human telomerase reverse transcriptase, hTERT) mRNA的表达量及其临床意义。方法以实时荧光定量RT-PCR检测95例结直肠癌、50例结直肠腺瘤息肉、25例结直肠增生性息肉、21例溃疡性结肠炎及20例正常结直肠黏膜组织中hTERT mRNA的表达量；分析结直肠癌组织中hTERT mRNA表达量与肿瘤病理特征及预后的关系。结果结直肠癌组hTERT mRNA表达量显著高于结直肠腺瘤息肉组、溃疡性结肠炎组、结直肠增生性息肉组和正常对照组(P<0.01)；腺瘤息肉中伴高级别上皮内瘤变者hTERT mRNA表达量明显高于伴低级别上皮内瘤变者(P<0.01),且两者均明显高于不伴上皮内瘤变者(P<0.05)；溃疡性结肠炎组hTERT mRNA表达量明显高于正常对照组(P<0.05)。结直肠癌组hTERT mRNA表达量与肿瘤分化程度、浸润深度、淋巴结转移、术后复发及TNM分期呈正相关(P<0.05),与术后生存期呈负相关(P<0.05)。 Cox多因素回归分析显示结直肠癌组织中hTERT mRNA表达量是影响术后预后的危险因素。结论结直肠癌组织中hTERT mRNA表达量与肿瘤重要病理特征相关,可成为评价结直肠癌术后预后的指标；结直肠腺瘤息肉和溃疡性结肠炎组织中hTERT mRNA高表达可能成为结直肠癌发生的预测指标。