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目的探讨胸苷酸合成酶(TS)和拓扑异构酶II(Topo-Ⅱ)在大肠癌原发灶及淋巴结转移灶的表达及临床意义。方法应用组织芯片及免疫组化技术,检测TS和Topo-II在135例大肠癌和60例淋巴结转移灶的表达情况。结果 TS在135例大肠癌和癌旁正常黏膜组织中的阳性表达率分别为54.81%和42.96%,差异无统计学意义(P>0.05),大肠癌TS表达与各临床病理参数无关(P>0.05),60例大肠癌淋巴结转移灶中TS阳性表达率为41.67%,与原发灶TS阳性表达率(53.33%)比较差异无统计学意义(P>0.05)及无相关性(r=0.045,P=0.732)。Topo-II在135例大肠癌和癌旁正常黏膜组织中的阳性表达率分别为53.33%和21.48%,差异有统计学意义(P<0.05),Topo-Ⅱ阳性表达率与大肠癌组织学分级有关,中分化腺癌高于高分化腺癌(P<0.05),60例大肠癌原发灶中Topo-Ⅱ阳性表达率(56.67%)显著高于淋巴结转移灶(31.67%,P<0.05)且呈正相关(r=0.261,P=0.044)。结论大肠癌原发灶与淋巴结转移灶TS和Topo-Ⅱ蛋白表达存在一定的差异,淋巴结转移灶耐药蛋白表达的检测对术后体内残存肿瘤细胞耐药性评估可能更为客观。
Objective To investigate the expression and clinical significance of thymidylate synthase (TS) and topoisomerase II (Topo-Ⅱ) in primary and metastatic colorectal cancer. Methods Tissue chips and immunohistochemistry were used to detect the expression of TS and Topo-II in 135 cases of colorectal carcinoma and 60 cases of lymph node metastasis. Results The positive rates of TS in 135 cases of colorectal cancer and adjacent normal mucosa were 54.81% and 42.96%, respectively, with no significant difference (P> 0.05). The expression of TS in colorectal carcinoma was not related to the clinicopathological parameters (P> 0.05). The positive expression rate of TS in 60 cases of lymph node metastasis of colorectal cancer was 41.67%, which was not significantly different from that of the primary tumor (53.33%) (P> 0.05) and no correlation (r = 0.045 , P = 0.732). The positive rates of Topo-II in 135 cases of colorectal cancer and adjacent normal mucosa were 53.33% and 21.48% respectively, with significant difference (P <0.05). The positive rate of Topo-Ⅱ was correlated with the histological grade of colorectal cancer (P <0.05). The positive rate of Topo-Ⅱ in 56 cases of primary colorectal cancer was significantly higher than that of lymph node metastasis (31.67%, P <0.05) And was positively correlated (r = 0.261, P = 0.044). Conclusion The expression of TS and Topo-Ⅱ protein in primary and metastatic lymph nodes of colorectal cancer is different. The detection of drug-resistant protein expression in lymph node metastasis may be more objective for evaluating the drug resistance of residual tumor cells in postoperative patients.