CAJ | 학술논문

目的：探讨G蛋白耦联受体31（GPR31）在结直肠癌患者中的表达及临床意义。方法收集1996年1月至2008年12月间于中山大学附属第一医院接受手术切除并经病理证实的321例结直肠癌患者的癌组织及癌旁正常组织标本。采用免疫组织化学法检测结直肠癌组织和正常黏膜组织标本中GPR31的表达水平并进行比较。根据结直肠癌组织平均吸光度值分界值，将患者分为GPR31低表达组和高表达组，比较两组患者的临床病理特征及预后情况，并分析影响预后的危险因素。结果 GPR31在结直肠癌组织中表达水平明显高于正常黏膜组织[平均吸光度值（0．063±0．014）比（0．045±0．020），P＝0．000]。以0．051的平均吸光度值为分界值将全组患者分为GPR31低表达组197例和高表达组124例。高表达组患者的远处转移率明显高于低表达组[12．1％（15／124）比4．1％（8／197），P＝0．007]。GPR31低表达组和高表达组的5年总生存率分别为84．3％和59．7％，无病生存率分别为82．2％和59．7％，差异均有统计学意义（均P＜0．05）。多因素分析结果显示，高龄、癌胚抗原异常、淋巴结转移、远处转移和GPR31高表达是影响结直肠癌患者总生存率和无病生存率的独立危险因素（均P＜0．05）。结论 GPR31在结直肠癌组织中表达上调，其高表达提示患者预后不良，可作为判断患者预后的参考指标。
목적：탐토G단백우련수체31（GPR31）재결직장암환자중적표체급림상의의。방법수집1996년1월지2008년12월간우중산대학부속제일의원접수수술절제병경병리증실적321례결직장암환자적암조직급암방정상조직표본。채용면역조직화학법검측결직장암조직화정상점막조직표본중GPR31적표체수평병진행비교。근거결직장암조직평균흡광도치분계치，장환자분위GPR31저표체조화고표체조，비교량조환자적림상병리특정급예후정황，병분석영향예후적위험인소。결과 GPR31재결직장암조직중표체수평명현고우정상점막조직[평균흡광도치（0．063±0．014）비（0．045±0．020），P＝0．000]。이0．051적평균흡광도치위분계치장전조환자분위GPR31저표체조197례화고표체조124례。고표체조환자적원처전이솔명현고우저표체조[12．1％（15／124）비4．1％（8／197），P＝0．007]。GPR31저표체조화고표체조적5년총생존솔분별위84．3％화59．7％，무병생존솔분별위82．2％화59．7％，차이균유통계학의의（균P＜0．05）。다인소분석결과현시，고령、암배항원이상、림파결전이、원처전이화GPR31고표체시영향결직장암환자총생존솔화무병생존솔적독립위험인소（균P＜0．05）。결론 GPR31재결직장암조직중표체상조，기고표체제시환자예후불량，가작위판단환자예후적삼고지표。
Objective To investigate the expression and clinical significance of G protein-coupled receptor 31(GPR31) in colorectal cancer tissue. Methods Cancer tissues and adjacent normal tissues of 321 cases with colorectal cancer confirmed by pathology and undergoing resection in the First Affiliated Hospital of Sun Yat-sen University from January 1996 to December 2008 were collected. The expression of GPR31 was examined by immunohistochemical staining. According to the expression level of GPR31 (A value=0.051), all the patients were divided into low GPR31 expression group and high GPR31 expression group. Clinicopathology and prognosis between the two groups were compared. Risk factors affecting prognosis were investigated. Results GPR31 expression was significantly higher in colorectal cancer tissues compared to adjacent normal tissues (mean A, 0.063±0.014 vs. 0.045±0.020, P<0.001). A total of 197 cancer tissue samples were defined as low expression and 124 as high expression. Significant difference was observed in the number of patient in pM classification between the two groups (P=0.007). High expression group had obviously higher distant metastasis rate than low expression group [12.1%(15/124) vs. 4.1%(8/197), P=0.007]. The 5-year survival rate and tumor-free survival rate were 84.3% and 82.2% in the low expression group, and both 59.7% in high expression group (all P<0.05). Multivariate analysis revealed elderly, abnormal CEA, lymphatic metastasis, distant metastasis and up-regulated GPR31 expression were independent risk factors of overall survival and disease-free survival in colorectal cancer patients (all P<0.05). Conclusions GPR31 expression is significantly up-regulated in colorectal cancer tissues. High GPR31expression indicates poor prognosis of colorectal cancer, and may be used as a predictive marker.