CAJ | 학술논문

目的：探讨结直肠腺瘤及癌变组织抑癌基因人第10号染色体缺失的磷酸酶及张力蛋白同源基因（PTEN）和环氧化酶-2（COX-2）的表达差异。方法采用免疫组织化学SP法分别检测30例正常肠黏膜组织、30例非腺瘤性息肉、60例腺瘤性息肉及30例肠癌组织中PTEN、COX-2蛋白的表达，分析其与临床病理特征的关系及二者表达相关性。结果 PTEN在正常肠黏膜、非腺瘤性息肉、腺瘤性息肉及肠癌组织中的阳性表达率逐渐降低，腺瘤性息肉和肠癌组织阳性率显著低于正常肠黏膜和非腺瘤性息肉组织，差异有统计学意义（ P <0.05）；COX-2在正常肠黏膜、非腺瘤性息肉、腺瘤性息肉及肠癌组织中的阳性表达率逐渐升高，腺瘤性息肉和肠癌组织COX-2阳性表达率显著高于正常肠黏膜组织，肠癌组织COX-2阳性表达率显著高于非腺瘤性息肉组织，差异均有统计学意义（ P <0.05）；腺瘤性息肉中直径≥1 cm者PTEN阳性率低于直径<1 cm者，绒毛状腺瘤PTEN阳性率低于管状腺瘤，腺瘤伴高级别上皮内瘤变及癌变的组织PTEN阳性率低于早期腺瘤，差异均有统计学意义（ P <0.05）；腺瘤性息肉中直径≥1 cm者COX-2阳性率高于直径<1 cm者，绒毛状腺瘤COX-2阳性率高于管状腺瘤，腺瘤伴高级别上皮内瘤变及癌变的组织COX-2阳性率高于早期腺瘤，差异均有统计学意义（ P <0.05）；腺瘤性息肉和肠癌组织PTEN和COX-2表达呈负相关（ P <0.05）。结论 PTEN和COX-2可能共同参与结直肠腺瘤癌变，并起重要负协同作用；联合检测或可预测腺瘤癌变，对腺瘤癌变早期诊断、治疗及预后评估有一定参考价值。
목적：탐토결직장선류급암변조직억암기인인제10호염색체결실적린산매급장력단백동원기인（PTEN）화배양화매-2（COX-2）적표체차이。방법채용면역조직화학SP법분별검측30례정상장점막조직、30례비선류성식육、60례선류성식육급30례장암조직중PTEN、COX-2단백적표체，분석기여림상병리특정적관계급이자표체상관성。결과 PTEN재정상장점막、비선류성식육、선류성식육급장암조직중적양성표체솔축점강저，선류성식육화장암조직양성솔현저저우정상장점막화비선류성식육조직，차이유통계학의의（ P <0.05）；COX-2재정상장점막、비선류성식육、선류성식육급장암조직중적양성표체솔축점승고，선류성식육화장암조직COX-2양성표체솔현저고우정상장점막조직，장암조직COX-2양성표체솔현저고우비선류성식육조직，차이균유통계학의의（ P <0.05）；선류성식육중직경≥1 cm자PTEN양성솔저우직경<1 cm자，융모상선류PTEN양성솔저우관상선류，선류반고급별상피내류변급암변적조직PTEN양성솔저우조기선류，차이균유통계학의의（ P <0.05）；선류성식육중직경≥1 cm자COX-2양성솔고우직경<1 cm자，융모상선류COX-2양성솔고우관상선류，선류반고급별상피내류변급암변적조직COX-2양성솔고우조기선류，차이균유통계학의의（ P <0.05）；선류성식육화장암조직PTEN화COX-2표체정부상관（ P <0.05）。결론 PTEN화COX-2가능공동삼여결직장선류암변，병기중요부협동작용；연합검측혹가예측선류암변，대선류암변조기진단、치료급예후평고유일정삼고개치。
Objective To study the differential expression of PTEN and COX-2 in colorectal adenomas and cancerous tissues. Methods Immunohistochemistry( streptavidin-perosidase method)was used to detect PTEN and COX-2 expression,respectively,in 30 cases of normal colonic mucosae,30 cases of non-adenomatous polyps,60 cases of colorectal adenomas and 30 cases of colorectal adenocarcinomas;statistical methods were used to analyze their relationships with clinical pathological characteristics,as well as the correlation between them. Results The PTEN-positive rates gradually decreased in normal colonic mucosae,non-adenomatous polyps,colorectal adenomas and colorectal adenocarcino-mas;and PTEN-positive rates in colorectal adenomas and colorectal adenocarcinomas were significantly lower than those in normal colonic muco-sae and non-adenomatous polyps( P <0. 05). The COX-2-positive rates gradually increased in normal colonic mucosae,non-adenomatous polyps,colorectal adenomas and colorectal adenocarcinomas;and COX-2-positive rates in colorectal adenomas and colorectal adenocarcinomas were significantly higher than those in normal colonic mucosae and non-adenomatous polyps( P <0. 05). The PTEN-positive rate in adenomas with ≥1 cm in diameter was significantly lower than that in adenomas with <1 cm in diameter,as well as the positive rate in villous adenoma sig-nificantly lower than that in tubular adenoma,the positive rate in adenomas with high-grade intraepithelial neoplasia and cancerous tissues signifi-cantly lower than that in colorectal adenomas at the early stages(all P <0. 05). The COX-2- positive rate in adenomas with≥1 cm in diameter was significantly higher than that in adenomas with <1 cm in diameter,as well as the positive rate in villous adenoma significantly higher than that in tubular adenoma,the positive rate in adenomas with high-grade intraepithelial neoplasia and cancerous tissues significantly higher than that in colorectal adenomas at the early stages(all P <0. 05). There was a negative correlation between the expression of PTEN and COX-2 in colorectal adenomas and cancerous tissues( P <0. 05). Conclusion PTEN might participate in the carcinogenesis of colorectal adenomas with COX-2, and plays an important negative synergistic effect with the latter. Combined detection,which might predict adenoma canceration,has certain refer-ence value to the early diagnosis,treatment and prognostic evaluation of colorectal adenoma.