CAJ | 학술논문

背景：越来越多的证据显示 CD44可作为结直肠腺癌干细胞的一个特异性的标志物，近年发现胚胎干细胞转录因子Oct4在结直肠腺癌中有表达。 　　目的：观察CD44+/Oct4+细胞在原发性结直肠腺癌组织中的数量、位置及分布方式。 　　方法：取108例结直肠腺癌、18例癌旁正常肠黏膜组织及18例伴不典型增生的结直肠腺瘤标本制成48点共3块组织芯片，应用免疫组织化学双重染色和苏木精-伊红染色，定位CD44+/Oct4+肿瘤细胞，观察计数并在苏木精-伊红切片的对应位置上观察其形态特征。 　　结果与结论：免疫组织化学双重染色结果显示，癌旁正常肠黏膜中未见CD44+/Oct4+细胞，在伴不典型增生的腺瘤中可见极少量CD44+/Oct4+细胞，结直肠腺癌中可见到少量CD44+/Oct4+细胞。双阳性细胞主要分布在腺管样结构基底膜侧或共壁腺体的共壁侧，呈小灶状或散在点状分布；细胞呈卵圆形或立方状，胞浆稀少，胞核规则，均质深染，呈卵圆形或高柱状。其数量与结直肠癌分化程度呈负相关(r=-0.579，P<0.01)，与肿瘤浸润深度有一定关联(r=0.236，P<0.05)。结果提示CD44+/Oct4+细胞可能是结直肠腺癌干细胞。
배경：월래월다적증거현시 CD44가작위결직장선암간세포적일개특이성적표지물，근년발현배태간세포전록인자Oct4재결직장선암중유표체。 　　목적：관찰CD44+/Oct4+세포재원발성결직장선암조직중적수량、위치급분포방식。 　　방법：취108례결직장선암、18례암방정상장점막조직급18례반불전형증생적결직장선류표본제성48점공3괴조직심편，응용면역조직화학쌍중염색화소목정-이홍염색，정위CD44+/Oct4+종류세포，관찰계수병재소목정-이홍절편적대응위치상관찰기형태특정。 　　결과여결론：면역조직화학쌍중염색결과현시，암방정상장점막중미견CD44+/Oct4+세포，재반불전형증생적선류중가견겁소량CD44+/Oct4+세포，결직장선암중가견도소량CD44+/Oct4+세포。쌍양성세포주요분포재선관양결구기저막측혹공벽선체적공벽측，정소조상혹산재점상분포；세포정란원형혹립방상，포장희소，포핵규칙，균질심염，정란원형혹고주상。기수량여결직장암분화정도정부상관(r=-0.579，P<0.01)，여종류침윤심도유일정관련(r=0.236，P<0.05)。결과제시CD44+/Oct4+세포가능시결직장선암간세포。
BACKGROUND:More and more studies employ CD44 as a specific marker of colorectal cancer stem cells. Oct4 is a transcription factor of embryonic stem cells, and it has been discovered recently that there is a higher expression in primary colorectal carcinoma. OBJECTIVE:To investigate the quantity, location and distribution of CD44+/Oct4+cells in primary colorectal carcinoma. METHODS:A total y of 108 cases of human colorectal carcinoma and 18 cases of normal mucosa, 18 cases of adenoma were col ected and made into three tissue microarrays, each containing of 48 dots. The locations of CD44+/Oct4+cells were detected by double-label immunohistochemical staining and hematoxylin-eosin staining. The morphologic features of them were investigated on hematoxylin-eosin staining at the same position.  RESULTS AND CONCLUSION:The results of double-label immunohistochemical staining demonstrated that there were no CD44+/Oct4+cells in normal intestine mucosa and a very smal amount of CD44+/Oct4+cells in adenoma, and double-positive cells could also be seen in colorectal carcinoma. The number of CD44+/Oct4+cells was rare and the cells were scattered or distributed focal y along the basement of gland basal side. The cells with scarce cytoplasm were square, and its nucleus was oval or high cylindrical, deeply stained and homogeneous. The quantity of CD44+/Oct4+cells was negatively correlated with the differentiation of colorectal cancer (r=-0.579, P<0.01), and was associated with the depth of tumor invasion (r=0.236, P<0.05). These findings indicate that CD44+/Oct4+cells may be colorectal cancer stem cells.