CAJ | 학술논문

目的探讨拓扑异构酶Ⅱα在结直肠癌组织中的表达水平及其与各临床病理因素、长期预后之间的关系.方法采用EnVision免疫组化法检测490例结直肠癌患者组织中拓扑异构酶Ⅱα蛋白的表达水平,分析它与各临床病理因素之间的关系,并采用Kaplan- Meier分析和多因素COX回归分析研究其在预后预测中的价值.结果拓扑异构酶Ⅱα的表达水平与T分期(P=0.042)、N分期(P =0.038)呈负相关；与局部复发率(P=0.053)也呈负相关,差异均有统计学意义.Kaplan- Meier分析显示拓扑异构酶Ⅱα的表达水平与患者的总生存时间(P=0.022)和无瘤生存时间(P=0.036)呈正相关.多因素COX回归分析显示拓扑异构酶Ⅱα的表达水平(P=0.017)、血清CEA(P＜0.001)、CA199(P=0.002)、肿瘤的分化程度(P=0.001)和Dukes分期(P ＜0.001)是结直肠癌患者总生存时间的独立影响因素.结论拓扑异构酶Ⅱα的表达水平是结直肠癌的独立预后因素,联合检测拓扑异构酶Ⅱα、CEA、CA199和肿瘤的分化程度有助于结直肠癌患者的预后判断和为患者选择个性化的治疗方案,尤其是那些早期的结直肠癌和结肠镜下切除的已癌变的息肉.
목적 탐토탁복이구매Ⅱα재결직장암조직중적표체수평급기여각림상병리인소、장기예후지간적관계.방법 채용EnVision면역조화법검측490례결직장암환자조직중탁복이구매Ⅱα단백적표체수평,분석타여각림상병리인소지간적관계,병채용Kaplan- Meier분석화다인소COX회귀분석연구기재예후예측중적개치.결과 탁복이구매Ⅱα적표체수평여T분기(P=0.042)、N분기(P =0.038)정부상관；여국부복발솔(P=0.053)야정부상관,차이균유통계학의의.Kaplan- Meier분석현시탁복이구매Ⅱα적표체수평여환자적총생존시간(P=0.022)화무류생존시간(P=0.036)정정상관.다인소COX회귀분석현시탁복이구매Ⅱα적표체수평(P=0.017)、혈청CEA(P＜0.001)、CA199(P=0.002)、종류적분화정도(P=0.001)화Dukes분기(P ＜0.001)시결직장암환자총생존시간적독립영향인소.결론 탁복이구매Ⅱα적표체수평시결직장암적독립예후인소,연합검측탁복이구매Ⅱα、CEA、CA199화종류적분화정도유조우결직장암환자적예후판단화위환자선택개성화적치료방안,우기시나사조기적결직장암화결장경하절제적이암변적식육.
Objective To determine the relationship between expression of topoisomerase Ⅱ α and clinicopathological factors,overall survival in colorectal caner.Methods Expression of topoisomerase Ⅱ α was measured using EnVision immunohistochemistry in 490 colorectal cancer patients.The relationship between topoisomerase Ⅱ α expression and various clinicopathological parameters was analyzed.Kaplan-Meier analyses and multivariate analyses were used to evaluate the significance of topoisomerase Ⅱ α expression in prognosis prediction.Results Overexpression of topoisomerase Ⅱ α was found to be related with lower T stage ( P =0.042 ),lower N stage ( P =0.038 ),and possibly with lower recurrence rate ( P =0.053 ).Kaplan- Meier analyses showed that overexpression of topoisomerase Ⅱ α was related with prolonged overall survival (P =0.022 ) and prolonged disease-free survival ( P =0.036).Multivariate analyses showed that elevated serum CEA ( P ＜ 0.001 ),elevated serum CA199 ( P =0.002 ),poor differentiation ( P =0.001 ),advanced Dukes stage ( P ＜ 0.001 ) and lower expression of topoisomerase Ⅱ α( P =0.017 ) were independent predictive factors for poor prognosis.Conclusions Expression of topoisomerase Ⅱ α is a favorable predictive factor for colorectal cancer,and would be useful in prognosis prediction and treatment selection for early colorectal cancer and malignant colorectal polyps,especially when it is used in combinations with serum CEA,CA199 and differentiation.