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目的探讨组织蛋白酶B(CatB)的表达与结直肠癌浸润和转移的关系及临床意义。方法采用免疫组织化学(免疫组化)法检测83例患者的结直肠癌原发灶、正常结肠黏膜、转移淋巴结和肝转移灶中CatB表达,用酶联免疫吸附法检测患者外周静脉血CatB水平。结果结直肠癌原发灶、正常结肠黏膜、转移淋巴结和肝转移灶中CatB表达阳性率分别为56.6%、31.3%、88.4%和85.0%,癌原发灶、肝转移灶和转移淋巴结中CatB表达阳性率高于正常肠黏膜组织(χ2=45.6124,P<0.01);转移淋巴结和肝转移灶中CatB表达阳性率高于癌原发灶(χ2=11.5982、4.3747,P<0.05)。DukesC、D期CatB表达阳性率高于DukesA、B期(χ2=16.9385,P<0.01),低分化腺癌和黏液腺癌CatB表达阳性率高于高、中分化腺癌(χ2=14.2338,P<0.01)。83例结直肠癌患者外周静脉血CatB平均水平为(5.9±2.9)ng/ml,30例健康志愿者CatB平均水平为(2.3±1.1)ng/ml,两者差异有统计学意义(t=6.6975,P<0.01)。DukesC、D期结直肠癌患者外周血CatB水平高于DukesA、B期患者。结论CatB增强表达与结直肠癌浸润转移有关,检测外周静脉血CatB水平对临床预测和判断淋巴结和肝转移有重要意义,有助于评价和观察临床治疗效果。
Objective To investigate the relationship between cathepsin B (CatB) expression and invasion and metastasis of colorectal cancer and its clinical significance. Methods The expression of CatB in primary colorectal cancer, normal colonic mucosa, metastatic lymph nodes and liver metastases of 83 patients was detected by immunohistochemistry (IHC). The levels of CatB in peripheral venous blood were measured by enzyme-linked immunosorbent assay . Results The positive rates of CatB in primary colorectal cancer, normal colorectal mucosa, metastatic lymph nodes and liver metastases were 56.6%, 31.3%, 88.4% and 85.0%, respectively. The positive rates of CatB in primary cancer, liver metastasis and metastatic lymph nodes were CatB (Χ2 = 45.6124, P <0.01). The positive rate of CatB in metastatic lymph nodes and liver metastases was higher than that in primary cancers (χ2 = 11.5982,4.3747, P <0.05). The positive rate of CatB in DukesC and D was higher than that in DukesA and B (χ2 = 16.9385, P <0.01). The positive rates of CatB in poorly differentiated adenocarcinoma and mucinous adenocarcinoma were higher than those in high and moderately differentiated adenocarcinoma (χ2 = 14.2338, P <0.01). The average CatB level in peripheral blood of 83 patients with colorectal cancer was (5.9 ± 2.9) ng / ml, and that of 30 healthy volunteers was (2.3 ± 1.1) ng / ml. The difference was statistically significant (t = 6.6975, P <0.01). DukesC, D stage colorectal cancer patients with higher levels of CatB than DukesA, B patients. Conclusion The increased expression of CatB is associated with the invasion and metastasis of colorectal cancer. The detection of Cat-B in peripheral venous blood is of great significance for clinical prediction and judgment of lymph node and liver metastasis, which is helpful to evaluate and observe the clinical effect.