E- cad、Snail表达与Dukes B期大肠癌浸润、转移、预后的关系

摘要

Objective To investigate the expression of E- cad and Snail in Dukes B colorectal cancer and its relation to tumor invasion, metastasis and prognosis. Methods The expression of E- cad and Snail was detected by immunohistochemical EnVision method in 45 cases of Dukes B colorectal cancer. Results The staining intensity of E- cad significantly was correlated with tumor differentiation, invasive depth, lymph node metastasis and Dukes stage, but not with age, gender, tumor size and pathological types. Among 45 cases of Dukes B colorectal cancer, E- cad was negatively expressed in 7 cases and positively expressed in 38, the 1- , 3- and 5- year survival rate of negative E- cad and positive E- cad cancer were 85.71%, 57.14%, 0.00%and 97.37%, 65.79%, 39.47%, respectively(P<0.01). The staining intensity of Snail was significantly correlated with differentiation, pathological types, invasive depth, venous vessel invasion, lymphatic vessel invasion, lymph node metastasis and Dukes stage, but not with age, gender and tumor size. In 45 cases of Dukes B cancer, Snail was negatively expressed in 26 cases and posi-tively expressed in 19 cases, the 1- , 3- and 5- year survival rate of negative Snail expression and positive Snail expression can-cer was 100.00%, 69.23%, 42.31% and 89.47%, 57.89%, 26.32%, respectively (P<0.01). The multivariate survival analysis demonstrated that lymph node metastasis, Dukes stage, expression of E- cad or Snail can predict survival of patients with col-orectal cancer. Conclusion Dukes B colorectal cancer with negative expression of E- cad or positive expression of Snail has poor prognosis.%目的研究E- cad、Snail表达与大肠癌侵袭、转移和预后的关系。方法采用免疫组化EnVision法，分别检测E- cad、Snail在正常大肠黏膜上皮、大肠腺瘤及大肠癌患者癌组织中的表达。结果 E- cad的表达与肿瘤分化程度、浸润深度、静脉、淋巴管侵犯、淋巴结转移与否及Dukes分期状况密切相关（均P＜0.05），而与年龄、性别、肿瘤大小、肿瘤病理类型无相关性（均P＞0.05）。45例Dukes B期的大肠癌患者中7例E- cad染色阴性，其1、3、5年生存率分别为85.71％、57.14％、0.00％；38例为中度阳性或强阳性，其1、3、5年生存率分别为97.37％、65.79％、39.47％，两者比较有统计学差异（P＜0.01）。Snail表达与肿瘤病理类型、分化程度、浸润深度、静脉、淋巴管侵犯、淋巴结转移与否及Dukes分期明显相关（均P＜0.05），而与年龄、性别、肿瘤大小无相关性（均P＞0.05）。45例Dukes B期的大肠癌患者中26例Snail染色阴性，其1、3、5年生存率分别为100.00％、69.23％、42.31％；19例为中度阳性或强阳性，其1、3、5年生存率分别为89.47％、57.89％、26.32％，两者比较有统计学差异（P＜0.01）。多因素分析结果显示：肿瘤淋巴结转移、Dukes分期、E- cad表达强度、Snail表达强度可预示患者术后生存情况（均P＜0.05）。E- cad与Snail在大肠癌组织中的表达呈显著负相关（r=-0.508，P＜0.01）。结论 E- cad与Snail可作为大肠癌患者的独立预后指标，预示患者术后生存情况。Dukes B期大肠癌患者中，E- cad阴性者预后明显较阳性者为差；Snail阳性者的预后明显较阴性者为差。