摘要
目的探讨左半结肠癌(LCC)、右半结肠癌(RCC)鼠类肉瘤病毒癌基因(KRAS)和血管内皮生长因子(VEGF)表达的差异性及其临床意义。方法选择2004年1月至2011年12月该院收治的218例结肠癌患者。采用PCR技术检测KRAS基因突变和免疫组织化学技术检测VEGF在LCC、RCC癌组织中的表达,比较LCC、RCC中KRAS和VEGF表达的差异性及其与临床病理特征的相关性。多因素Logistic回归分析影响LCC、RCC肝转移的因素。结果 LCC、RCC的KRAS基因突变率分别为29.41%、42.24%,二者比较差异有统计学意义(P<0.05)。RCC发病年龄超过60岁、低分化、原发肿瘤大于5cm、脉管及神经侵犯、Ⅳ期病例数、初诊时合并肝转移等构成比均高于LCC(P<0.05),但是初诊时合并肠梗阻和可切除肝转移比例LCC高于RCC(20.58%vs.11.21%和26.27%vs.16.67%,P<0.05)。LCC、RCC的VEGF阳性表达率分别为64.71%、80.17%,二者比较差异有统计学意义(P<0.01)。多因素Logistic回归分析结果显示,肿瘤部位、大小、分化程度、脉管侵犯、KRAS基因突变率和VEGF阳性表达率均是结肠癌肝转移的危险因素。LCC、RCC总5年生存率分别是71.61%、59.53%,二者比较差异有统计学意义(P<0.05)。结论 LCC、RCC的生物学特性存在较大差异性,KRAS基因突变率和VEGF阳性表达率均是结肠癌肝转移的危险因素。
Objective To investigate the different expression of KRAS gene and vascular endothelial growth factor(VEGF)between the left colon cancer(LCC)and right colon cancer(RCC)and their clinical significance.Methods Retrospectively analyzed 218 patients with colon cancer from January 2004 to December 2011.The KRAS gene mutation was detected by PCR,the expression of VEGF was detected by immunohistochemistry in LCC and RCC tissues.The relation between the different expressions and the clinicopathological features were compared.Multivariate regression model was used to analyze the factors affecting liver metastasis of LCC and RCC by Logistic regression analysis.Results The KRAS gene mutation rates in LCC and RCC tissues were 29.41%and 42.24%,there was statistically significant difference(P<0.05).The composition of RCC was higher than that of LCC at the age of onset more than 60 years,poor differentiation,primary tumor greater than 5 cm,vascular and nerve invasion,number ofⅣstage cases,and liver metastases at the time of initial diagnosis(P<0.05).However,the proportions of combined with intestinal obstruction and resectable liver metastasis at the time of initial diagnosis in LCC were higher than those of RCC(20.58%vs.11.21%and 26.27%vs.16.67%,P<0.05).The positive expression rates of VEGF in LCC and RCC were respectively 64.71%and 80.17%,the difference was statistically significant(P<0.01).Logistic regression analysis showed that tumor location,size,differentiation,vascular invasion,KRAS gene mutation rate and VEGF positive expression rate were all risk factors for liver metastasis of colon cancer.The 5-year survival rate of LCC and RCC were 71.61%and 59.53%,the difference was statistically significant(P<0.05).Conclusion There are great differences in the biological characteristics between LCC and RCC,KRAS gene mutation rate and VEGF positive expression rate are the risk factors for liver metastasis of colon cancer.
作者
邹劲林
牛斌
莫湘琼
凌志东
ZOU Jinlin;NIU Bin;MO Xiangqiong;LING Zhidong(Department of Gastroenterolog,the Fifth Affiliated Hospital of Sun Yat-Sen University,Zhuhai,Guangdong 519000,China)
出处
《重庆医学》
CAS
2018年第31期4010-4013,4017,共5页
Chongqing medicine
基金
珠海市科技计划项目(20181117A010009)
关键词
结肠肿瘤
鼠类肉瘤病毒癌基因
血管内皮生长因子
免疫组织化学
colonic neoplasms
kirsten rat sarcoma viral oncogene
vascular endothelial growth factors
immunohistochemistry
