【摘要】：目的:檢測上皮間質轉化(epithelial-mesenchymal transition,EMT)相關標志物E鈣黏素、波形蛋白在無遠處轉移的結腸癌組織、伴有肝轉移的結腸癌組織及結腸癌肝轉移組織的表達情況,同時分析結腸癌組織中E鈣黏素表達在不同臨床病理特征之間表達差異性,進一步探討EMT在結腸癌轉移中的意義。方法:收集2011年1月至2014年12月山西醫(yī)科大學第一醫(yī)院及山西省腫瘤醫(yī)院收治的未發(fā)生遠處轉移的結腸癌患者(15例)及結腸癌伴肝轉移且同期行手術切除患者(20例)的結腸癌組織、結腸癌肝轉移組織病理蠟塊(石蠟包埋標本)。采用免疫組化方法(SP法)檢測相應癌組織的E鈣黏素、波形蛋白的表達情況。隨機選擇10個高倍視野(40×),每個視野計數100個細胞,以不表達或陽性細胞數25%判為(-),當細胞染色較強或陽性染細胞數75%判為(+),其余陽性細胞數25%~75%判為(±),其中(-)、(±)均視為陰性,并測量組織中蛋白表達平均灰度值。利用SPSS軟件進行數據分析,定量資料之間比較采用t檢驗,計數資料之間比較采用χ2檢驗,均以雙側檢驗P0.05表示差異具有統計學意義。結果:(1)E鈣黏素表達在無遠處轉移及有遠處轉移的結腸癌組織表達陽性率分別為86.7%(13/15)、35.7%(5/14),差異具有統計學意義(P0.05);(2)E鈣黏素主要表達于細胞膜,在結腸癌組織及同其期肝轉移組織中陽性表達為分別為25%(5/20)、40%(8/20),平均灰度值為173.075±29.770、175.540±26.5738,差異不具有統計學意義(P0.05);波形蛋白在結腸癌組織、結腸癌肝轉移組織中間質細胞表達明顯,并偶見腫瘤細胞胞漿表達,在兩組內陽性表達率分別為80%(16/20)、65%(13/20),平均灰度值分別為110.079±22.434、100.187±13.891,差異不具有統計學意義(P0.05);(3)E鈣黏素在結腸癌組織表達與性別、年齡、腫瘤大小、分化程度、浸潤深度等臨床病理特征之間表達差異不具有統計學意義(P0.05)。結論:(1)E鈣黏素在未發(fā)生遠處轉移和已發(fā)生遠處轉移結腸癌組織中的表達差異對評估結腸癌轉移風險可能具有重要的參考價值。(2)EMT標志物(E鈣黏素、波形蛋白)在結腸癌組織及同期肝轉移組織中表達水平相似,提示早期結腸癌細胞發(fā)生上皮間質轉化,有利于腫瘤的發(fā)生發(fā)展,當腫瘤轉移至新的部位,可能又發(fā)生間質上皮轉化,有利于腫瘤在新的環(huán)境(如肝臟)中生長。(3)腫瘤組織的異質性造成不同區(qū)域組織生物學特性的不完全一致可能是分子標記物表達不均勻的原因。
[Abstract]:Objective: to detect the expression of E-cadherin and vimentin in colon cancer tissues without distant metastasis, colon cancer tissues with liver metastasis and colon cancer liver metastases. At the same time, we analyzed the difference of E-cadherin expression among different clinicopathological features in colon cancer tissues, and further discussed the significance of EMT in colon cancer metastasis. Methods: from January 2011 to December 2014, 15 patients with colon cancer without distant metastasis and 15 patients with colon cancer accompanied with liver metastasis who were admitted to the first Hospital of Shanxi Medical University and Shanxi Cancer Hospital were collected. (20 cases) of colon cancer, Pathological wax masses (paraffin embedded specimens) of liver metastases from colon cancer. The expression of E-cadherin and vimentin was detected by immunohistochemical method (SP). Ten high-power visual fields (40 脳) were randomly selected. 100 cells were counted in each field, and 25% of the cells without expression or positive were judged as (-), and 75% of the cells with strong staining or positive staining were judged as (),. 75% of the other positive cells were found to be (鹵), of which (-), (鹵) were considered negative, and the average gray value of protein expression was measured. The data were analyzed by SPSS software. T test was used to compare the quantitative data and 蠂 2 test was used to compare the count data. Results: (1) the positive rates of E-cadherin expression were 86.7% (13 / 15) and 35.7% (5 / 14) in colon cancer tissues with no distant metastasis and distant metastasis respectively (P0.05). (2) E-cadherin was mainly expressed on cell membrane. The positive expression of E-cadherin was 25% (5 / 20) and 40% (8 / 20) in colon cancer and liver metastasis respectively, and the average gray value was 173.075 鹵29.770175.540 鹵26.5738. The difference was not statistically significant (P0.05). The expression of vimentin in the stromal cells of colon cancer and liver metastases was obvious, and the expression of vimentin in the cytoplasm of tumor cells was occasionally observed. The positive expression rates of vimentin in the two groups were 80% (16 / 20) and 65% (13 / 20), respectively. The average gray value was 110.079 鹵22.434100.187 鹵13.891respectively, the difference was not statistically significant (P0.05). (3) there was no significant difference between the expression of E-cadherin and clinicopathological features such as sex, age, tumor size, differentiation, depth of invasion and so on (P0.05). Conclusion: (1) the difference of E-cadherin expression in colorectal cancer tissues without or without distant metastasis may be of important value in assessing the risk of colon cancer metastasis. (2) the EMT marker (E-cadherin) may be useful in evaluating the risk of colon cancer metastasis. The expression level of vimentin in colon cancer tissues and liver metastasis tissues is similar, suggesting that the epithelial interstitial transformation of colon cancer cells occurs in the early stage, which is beneficial to the development of tumor, and when the tumor metastases to a new site, the expression of vimentin is similar. Another transition of the interstitial epithelium may occur. (3) the heterogeneity of tumor tissues may cause the heterogeneity of tissue biological characteristics in different regions, which may be the reason for the uneven expression of molecular markers.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R735.35

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