Wnt及整合素信号通路在大肠侧向发育型肿瘤中的表达及与其内镜形态学之间的关系

摘要

目的 探究Wnt信号通路及整合素信号通路在大肠侧向发育型肿瘤(LST)中的表达及与其内镜形态学之间的关系,以期对LST特殊生长方式的发生机制有一定的认识.方法 随机选取中南大学湘雅二医院2010年1月1日～2015年6月10日期间确诊的LST 52例,按内镜形态学分,结节混合型37例,颗粒均一型6例,扁平隆起型5例,假凹陷型4例;应用免疫组织化学方法测定Wnt信号通路中的β-catenin、磷酸化GSK-3β,及整合素信号通路中的Paxillin、ILK在此52例LST及对照组15例突起性腺瘤(PA)中的表达;应用统计学方法分析β-catenin、磷酸化GSK-3β、Paxillin、ILK在LST中的表达与其内镜形态学之间的关系.结果 β-catenin在LST中的表达较PA中的表达升高(P＜0.05);β-catenin、磷酸化GSK-3β、Paxillin、ILK在LST的假凹陷型中的表达较PA中的表达均升高(P＜0.05);β-catenin、磷酸化GSK-3β、ILK,在LST中的表达存在一定的相关性(P＜0.05),在PA中的表达不具有相关性(P＞0.05).结论 LST的假凹陷型,可能具有不同于其他内镜分型的特殊发生机制;LST中,ILK对Wnt信号通路的表达上调可能发挥一定的作用.%Objective To investigate the expression of Wnt and integrin pathways in colorectal laterally spreading tumors (LSTs) and their correlation with the different endoscopic subtypes of LSTs to better understand the special growth mechanism of LSTs.Methods Fifty-two patients with colorectal LSTs were randomly selected from the cases diagnosed between January 1,2010 and June 10,2015 in our hospital,including 37 of nodular mixed type (LST-G-M),60 of homogeneous type (LST-G-H),5 of fiat elevated type (LST-NG-FE),and 4 of pseudodepressed type (LST-NG-PD).The expression of β-catenin,phosphoGSK-3β,paxillin and ILK in 52 colorectal LSTs and 15 protruded adenomas (PAs) were investigated by immunohistochemical staining.The correlation of β-catenin,phospho-GSK-3β,paxillin and ILK expressions among the endoscopic subtypes of LSTs were analyzed.Results β-catenin expression was significantly higher in LSTs than in Pas (P＜0.05).β-catenin,phospho-GSK-3β,paxillin and ILK expressions were significantly higher in LST-NG-PD than in Pas (P＜0.05).The expressions of β-catenin,phospho-GSK-3β and ILK expression were significantly correlated in LSTs (P＜0.05) but not in PAs (P＞0.05).Conclusion The macroscopic feature of LST-NG-PD may result from a special mechanism of development distinct from other endoscopic subtypes;ILK may play a role in regulating Wnt signaling in LSTs.