直肠癌中碳酸酐酶Ⅸ表达的临床意义

摘要

目的 探讨缺氧标记物碳酸酐酶Ⅸ(carbonic anhydrases-Ⅸ,CA-Ⅸ)作为直肠癌肿瘤标记物和转移相关蛋白的意义.方法 应用蛋白免疫印迹(Western-blot)方法检测CA-Ⅸ在正常直肠组织,直肠腺瘤,原发直肠癌灶、系膜组织、肝转移组织中的差异性表达,与血管内皮生长因子(VEGF)比较,判断CA-Ⅸ作为直肠癌发生和转移相关因子的意义.结果 直肠癌灶CA-Ⅸ和VEGF阳性率分别为68.8%和74.2%,高于正常直肠组织和直肠腺瘤组织(P<0.01).直肠癌灶和系膜组织中CA-Ⅸ的表达与淋巴结转移有关(r值为-0.22和0.28,P均<0.05),N,组癌灶CA-Ⅸ阳性表达率为85.5%,高于N1淋巴结转移组的66.7%和N2淋巴结转移组的64.5%.N0组系膜组织CA-Ⅸ阳性率5.5%,低于N1期的26.2%和N2期的29.0%.癌旁系膜组织CA-Ⅸ水平预测直肠癌淋巴转移特异性94.5%,肝转移特异性59.6%.结论 癌组织内CA-Ⅸ高表达与直肠癌的发生、发展和浸润转移有一定关系,可作为相关肿瘤标记物和转移相关蛋白,为术后靶向治疗提供依据.%Objective To explore the biological functions of carbonic anhydrases Ⅸ (CA-Ⅸ) be considered as a diagnostic markers of patients with rectal cancer, and as an early associated protein to diagnosis lymph or liver metastasis. Methods Adopt Western-blot method to examinate the different expression of CA-Ⅸ in 128 pathologically diagnosed rectal cancer tissues, mesorectum, metastatic cancer tissues of the liver and in 30 normal rectal mucosa and rectal adenoma. The datas were compared with VEGF, to study their diagnostic significance and relationships with lymphatic or hepatic metastasis. Results The positive expression rates of CA-Ⅸ and VEGF in rectal cancer tissues were 74. 2 ％ and 68.8 ％, repectively,which were both higher than those of normal rectal mucosa and adenoma(P＜0. 01 ). The positive expressions of CA-Ⅸ in carcinoma tissues and mesorectum have relationship with lymph metastasis (r= - 0. 22 and 0. 28,P＜0. 05). Negative lymph node patients has a higher rate of CA-Ⅸ positivity(85. 5 ％)in rectal tissues than patients with positive lymph node(N1and N2 ), which positivity was 66. 7％ and 64. 5％ respectively( P＜0. 05). But negative lymph node patients has a lower rate of CA-Ⅸ positivity(5. 5 ％)in mesorectum than patients with positive lymph node( N1 and N2 ), which positivity was 26. 2 ％ and 29. 0 ％ respectively(P＜0. 05). The specificity of CA-Ⅸ in mesorectal tissues to diagnose the rectal cancer's lymphatic and hepatic metastasis were 94. 5 ％ and 59. 6 ％ respectively. Conclusion The higher expressions of CA-Ⅸ in rectal cancer tissues were related to tumorigenesis, progression and metastasis, it can be regarded as the diagnostic markers and associated protein to improve the effectiveness of targeted treatment in rectal cancer patients.