[目的]探讨人第10号染色体缺失的磷酸酶(PTEN)、环氧化酶-2(COX2)蛋白在复发转移性大肠癌患者组织中的表达及临床意义.[方法]选取2016年2月至2017年2月本院诊治的复发转移性大肠癌患者50例(复发转移组),另外同期在本院接受治疗的复发未转移大肠癌患者50例记为单纯复发组,取同期在本院接受治疗的初发大肠癌患者50例记为初发大肠癌组,另取同期本院接受肠镜检查(有肠道不适等相关症状就诊)结果正常的50例健康者作为对照组.分别采用免疫组化法检测四组研究对象PTEN、COX2蛋白表达水平并比较,并分析其与复发转移性大肠癌患者预后的相关性.[结果]复发转移组患者的PTEN蛋白表达阳性率为20.00％(10/50),显著低于其他三组,而单纯复发组又显著低于初发大肠癌组与对照组;同时,复发转移组患者的COX2蛋白表达阳性率为86.00％(43/50),显著高于其他三组,而单纯复发组又显著高于初发大肠癌组与对照组,差异均有统计学意义(均P <0.05);初发大肠癌组PTEN蛋白表达阳性率低于对照组,而COX2蛋白表达阳性率高于对照组,差异均有统计学意义(均P <0.05).复发转移性大肠癌存活患者的PTEN蛋白表达阳性率为32.14％ (9/28),显著高于死亡患者的4.55％ (1/22),而COX2蛋白表达阳性率为75.00％(21/28),显著低于死亡患者的100.00％ (22/22),差异均有统计学意义(均P <0.05).Pearson相关性分析显示:复发转移性大肠癌患者存活率与PTEN蛋白表达水平呈显著正相关(r = 0.673,P =0.000),而与COX2蛋白表达水平呈显著负相关(r = -0.652,P =0.000).[结论]PTEN、COX2蛋白表达水平可有效早期诊断复发转移性大肠癌患者,且能作为患者评估预后的指标之一.%[Objective]To study the expression and clinical significance of phosphatase and tensin homolog deleted on chromosome ten (PTEN) and Cyclic oxidase-2 (COX2) protein in patients with recurrent metastatic colorectal cancer.[Methods]From February 2016 to February 2017,50 patients with recurrent and metastatic colorectal cancer (recurrence and metastasis group) and 50 patients with recurrent and unmetastatic colorectal cancer treated in our hospital from February 2016 to February 2017 were selected as simple recurrence group. Fifty patients with primary colorectal cancer who were treated in our hospital at the same time were selected as the primary colorectal cancer group, and 50 healthy persons who received enteroscopy examination (with intestinal discomfort and other related symptoms) as the control group. The expression of PTEN, COX2 protein was detected by immunohistochemical method in the four groups and the correlation between the expression of PTEN,COX2 protein and the prognosis of patients with recurrent and metastatic colorectal cancer was analyzed.[Results]The positive rate of PTEN protein expression in patients with recurrence and metastasis was 20.00％ (10/50), which was significantly lower than that in the other three groups,while that in the simple recurrence group was significantly lower than that in the primary colorectal cancer group and the control group. At the same time, the positive rate of COX2 protein expression in patients with recurrence and metastasis was 86.00％ (43/50), which was significantly higher than that of the other three groups, and that of simple recurrence group was significantly higher than that of the primary colorectal cancer group and the control group. The difference was statistically significant (mean P <0.05). The positive rate of PTEN protein expression in the primary colorectal cancer group was lower than that in the control group, but the positive rate of COX2 protein expression was higher than that in the control group (mean P <0.05). The positive rate of PTEN protein expression in the survival patients was 32.14％ (9/28),which was significantly higher than that in the dead patients (4.55％) (1/22). The positive rate of COX2 protein expression was 75.00％ (21/28). It was significantly lower than that in the death patients (100.00％, 22/22),and the difference was statistically significant (P <0.05). The correlation analysis showed that the survival rate of patients with recurrent and metastatic colorectal cancer was positively correlated with the expression level of PTEN protein (r =0. 673, P < 0.05). There was a significant negative correlation between the expression of COX2 protein and the expression of COX2 protein (r = -0.652, P =0.000).[Conclusion] The expression of PTEN,COX2 protein can be used for early diagnosis of recurrent and metastatic colorectal cancer and as a prognostic indicator.
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