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成人大肠腺瘤伴鸡皮样黏膜改变的临床意义

发布日期:2014-10-22 12:21:51 文章来源: 作者次数:1497

    【摘要】
        目的 研究伴鸡皮样黏膜(CSM)改变的成人大肠腺瘤生物学特性及其临床意义。
        方法 采用免疫组化SP法及酶联免疫吸附试验(ELISA)检测正常大肠黏膜、伴CSM的大肠腺瘤、不伴CSM的大肠腺瘤和大肠腺瘤癌变标本中代表细胞增殖的标志物Ki-67、COX-2和细胞凋亡相关因子survivin、caspase-3蛋白的表达情况。
        结果 免疫组化结果提示在大肠腺瘤癌变组织、伴CSM的大肠腺瘤、不伴CSM的大肠腺瘤及正常大肠黏膜中Ki-67、COX-2的表达呈递减趋势,而survivin和caspase-3的表达呈递增趋势。蛋白质定量分析(ELISA法)结果提示Ki-67、COX-2、survivin、caspase-3含量在伴CSM的大肠腺瘤与腺瘤癌变组织间比较差异均无统计学意义(P>0.05),伴CSM的大肠腺瘤与不伴CSM的大肠腺瘤比较差异均有统计学意义(P<0.05),正常大肠黏膜与伴CSM的大肠腺瘤、大肠腺瘤癌变组织间比较差异均有统计学意义(P<0.05)。
        结论 伴CSM的大肠腺瘤具有有别于不伴有CSM的大肠腺瘤的生物学特性,其细胞增殖活跃而调亡受抑制,易发生癌变。
    【关键词】腺瘤,结肠;癌变;细胞增殖;细胞凋亡;鸡皮样黏膜


    【Abstract】
    Objective   To explore the biological features of colorectal adenoma with chicken-skin mucosa (CSM) and its clinical significance.
    Methods   Expression of cell proliferation markers (Ki-67 and COX-2) and apoptosis-related factors (survivin and caspase-3) in normal colorectal mucosa, colorectal adenoma without CSM, colorectal adenoma with CSM and colorectal adenocarcinoma were detected by immunohistochemistry SP method and enzyme-linked immunosorbent assay (ELISA).
    Results   Immunohistochemical results revealed a decreased trend in expressions of Ki-67 and COX-2 from colorectal adenocarcinoma through colorectal adenoma with and without CSM to normal colorectal mucosa, while the expressions of survivin and caspase-3 showed an increased trend. By ELISA, the expressions of Ki-67, COX-2, surviving and caspase-3 showed no significant difference (P>0.05) between colorectal adenoma with CSM and colorectal adenocarcima, while these variables were significantly different (P<0.05) between colorectal adenoma with and without CSM, so as well between normal colorectal mucosa and other 3 groups.
    Conclusion   The biological characteristics of colorectal adenoma with CSM are different from those without, showing an activated cell proliferation and inhibited cell apoptosis with increased carcinogenesis risk.
    【Key words】Adenoma,colon;Neoplasia;Cell proliferation;Apoptosis;Chicken-skin mucosa

    (作者:关景明 李春明 张学彦 郭宇栋 马骁)
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