Słomka Marta, Stasikowska Olga, Wagrowska-Danilewicz Małgorzata, Danilewicz Marian, Małecka-Panas Ewa
Department of Digestive Tract Diseases, Medical University of Lodz, Poland.
Pol Merkur Lekarski. 2010 Dec;29(174):351-6.
Colorectal carcinoma is the most common gastrointestinal malignancy in the world. The survival of patients with colorectal cancer has not varied appreciably in recent years. The knowledge that genetic factors could play a role in the etiology and prognosis of patients with sporadic colorectal cancer has opened up new lines of research. The aim of the study was to evaluate a group of patients with colorectal cancer and the possible influence on the prognosis of immunohistochemical hMLH1, hMSH2 and CD34 expression.
37 cases of colorectal cancer were included in this study. HMLH1, hMSH2 and CD34 protein expression in tumor tissue sections was determined using immunohistochemical staining with specific monoclonal antibodies. A total of 37 tumors were analyzed for histopathology. The immunoexpression status of MMR genes was correlated with cancer stage, location, histology, gender and CD34 immunoexpression.
Of the 37 cases immunohistochemical analysis showed 13 (35.1%) had loss of expression of hMLH1, 5 (13.5%) had loss of expression of hMSH2, and five cases had loss of expression of both proteins. Multivariate analysis showed that right side dominance (p<0.05) poorly differentiated and male (p<0.05) were associated with loss of expression of hMLH1 or hMSH2. Loss of expression of hMLH1 or hMSH2 correlated with low CD34 expression (p>0.05). CD34 immunoexpression was higher in the left side tumor location, stage D Dukes'a (p<0.05) and G2 (p<0.05).
These results confirm that sporadic colorectal MMR-defective adenocarcinomas display certain specific morphological characteristics. However, these pathological features are not sufficiently predictive and immunohistochemistry is needed to identify such tumours accurately. The researches on angiogenesis of cancer cells can be used as prognostic factors for the patients with colorectal cancer.
结直肠癌是世界上最常见的胃肠道恶性肿瘤。近年来,结直肠癌患者的生存率并无明显变化。遗传因素可能在散发性结直肠癌患者的病因和预后中起作用这一认识开辟了新的研究方向。本研究的目的是评估一组结直肠癌患者以及免疫组化hMLH1、hMSH2和CD34表达对预后的可能影响。
本研究纳入37例结直肠癌病例。使用特异性单克隆抗体通过免疫组化染色确定肿瘤组织切片中HMLH1、hMSH2和CD34蛋白的表达。对总共37个肿瘤进行组织病理学分析。MMR基因的免疫表达状态与癌症分期、位置、组织学、性别和CD34免疫表达相关。
在37例病例中,免疫组化分析显示13例(35.1%)hMLH1表达缺失,5例(13.5%)hMSH2表达缺失,5例两种蛋白均表达缺失。多因素分析显示右侧优势(p<0.05)、低分化和男性(p<0.05)与hMLH1或hMSH2表达缺失相关。hMLH1或hMSH2表达缺失与低CD34表达相关(p>0.05)。CD34免疫表达在左侧肿瘤位置、Dukes分期D期(p<0.05)和G2期(p<0.05)更高。
这些结果证实散发性结直肠癌错配修复缺陷腺癌具有某些特定的形态学特征。然而,这些病理特征的预测性不足,需要免疫组化来准确识别此类肿瘤。对癌细胞血管生成的研究可作为结直肠癌患者的预后因素。