Baldus S E, Mönig S P, Hanisch F-G, Zirbes T K, Flucke U, Oelert S, Zilkens G, Madejczik B, Thiele J, Schneider P M, Hölscher A H, Dienes H P
Institute of Pathology, Medical Faculty, University of Cologne, Cologne, Germany.
Histopathology. 2002 May;40(5):440-9. doi: 10.1046/j.1365-2559.2002.01389.x.
The significance of MUC1, MUC2 and sialylated Lewis blood group antigens as prognostic markers in colorectal adenocarcinoma was investigated in a large series of patients because previous investigations revealed inconsistent results due to unrelated tumour samples from different patient groups and methodological differences.
Tissues from 243 patients with colorectal adenocarcinoma were stained immunohistochemically. MUC1 showed a strong immunoreactivity (in more than 35% of the tumour area) in 32.5%, MUC2 in 51.0%, sialyl-Lewis(x) in 67.9% and sialyl-Lewis(a) in 73.7% of the cases, respectively. MUC1 immunoreactivity displayed a significant correlation with tumour progression as reflected by advancing pTNM staging and poor differentiation. MUC2 expression was significantly stronger in mucinous adenocarcinomas. Sialyl-Lewis(x) immunostaining correlated with the extent of lymph node metastasis as well as low cytological differentiation. According to univariate and multivariate analysis (P < 0.0001) only MUC1 reactivity represented a marker of worse survival probability, opposed to the sialylated Lewis antigens that did not exert a predictive value.
According to our data, MUC1 and sialyl-Lewis(x) immunoreactivity exhibit statistically significant correlations with established markers of tumour progression. However, only MUC1 presents as an independent prognostic factor of colorectal adenocarcinoma.
由于先前的研究因不同患者群体的肿瘤样本不相关以及方法学差异而得出不一致的结果,因此在一大系列患者中研究了MUC1、MUC2和唾液酸化Lewis血型抗原作为结直肠癌预后标志物的意义。
对243例结直肠癌患者的组织进行免疫组织化学染色。MUC1在32.5%的病例中显示强免疫反应性(肿瘤面积超过35%),MUC2为51.0%,唾液酸化Lewis(x)为67.9%,唾液酸化Lewis(a)为73.7%。MUC1免疫反应性与肿瘤进展显著相关,表现为pTNM分期进展和低分化。MUC2在黏液腺癌中的表达明显更强。唾液酸化Lewis(x)免疫染色与淋巴结转移程度以及低细胞分化相关。根据单因素和多因素分析(P < 0.0001),只有MUC1反应性代表较差生存概率的标志物,而唾液酸化Lewis抗原没有预测价值。
根据我们的数据,MUC1和唾液酸化Lewis(x)免疫反应性与既定的肿瘤进展标志物存在统计学显著相关性。然而,只有MUC1是结直肠癌的独立预后因素。