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目的探讨血吸虫病合并大肠癌与p53、环氧合酶-2(COX-2)、Bax、c-myc蛋白表达间的相关性。方法 160例大肠癌患者分为2组:血吸虫病组(慢性血吸虫病合并大肠癌)80例和非血吸虫病组(单纯性大肠癌)80例。采用组织芯片及免疫组化EnVision法检测,比较2组患者中p53、COX-2、Bax、c-myc蛋白的表达水平。结果 p53蛋白在血吸虫病组的阳性表达率与阳性表达水平均低于非血吸虫病组,但差异均无统计学意义(P均>0.05);COX-2蛋白在两组中均为阳性表达,血吸虫病组表达水平显著高于非血吸虫病组(P<0.01);两组Bax蛋白阳性表达率与阳性表达水平差异均无统计学意义(P均>0.05)。血吸虫病组c-myc蛋白阳性表达率显著高于非血吸虫病组,但阳性表达水平显著低于非血吸虫病组(P均<0.01)。结论血吸虫感染可能对大肠癌组织细胞中p53缺失有一定的影响,对COX-2蛋白的过表达有促进作用,是一个间接致癌因素;Bax与血吸虫感染无相关性;慢性血吸虫感染可能引起c-myc蛋白的持续性低水平表达。
Objective To investigate the correlation between the expression of p53, cyclooxygenase-2 (COX-2), Bax and c-myc protein in schistosomiasis complicated with colorectal cancer. Methods 160 patients with colorectal cancer were divided into two groups: 80 cases of schistosomiasis group (chronic schistosomiasis with colorectal cancer) and 80 cases of non-schistosomiasis group (simple colorectal cancer). The expression of p53, COX-2, Bax and c-myc protein in the two groups were compared by tissue microarray and EnVision immunohistochemistry. Results The positive expression rate and positive expression level of p53 protein in schistosomiasis group were lower than those in non-schistosomiasis group, but the difference was not statistically significant (all P> 0.05); COX-2 protein was positive in both groups, The expression of Bax in schistosomiasis group was significantly higher than that in non-schistosomiasis group (P <0.01). There was no significant difference between the two groups in the expression of Bax protein and the positive expression level (all P> 0.05). The positive expression rate of c-myc in schistosomiasis group was significantly higher than that in non-schistosomiasis group, but the positive expression level of c-myc protein in schistosomiasis group was significantly lower than that in non-schistosomiasis group (all P <0.01). Conclusion Schistosoma infection may affect p53 loss in colorectal cancer cells and promote COX-2 overexpression, which is an indirect carcinogenic factor. There is no correlation between Bax and schistosomiasis infection. Chronic schistosome infection may cause c- Sustained low-level expression of myc protein.