作者：王成兴，李晓平，赵景林，李尚仁，谭群英，何耀明

单位：江门市中心医院(中山大学附属江门医院) 胃肠外科，广东 江门529000

Authors:  Wang Chengxing, Li Xiaoping, Zhao Jinglin, Li Shangren, Tan Qunying, He Yaoming

Unit:  Department of Gastrointestinal Surgery, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen 529000, Guangdong, China

摘要：

目的 研究粪便脱落细胞Gankyrin蛋白检测对结直肠癌(CRC)早期诊断的临床意义。方法 收集2013年12月至2014年12月江门市中心医院胃肠外科收治的100例CRC患者为随访组,其肿瘤组织(T)、粪便脱落细胞(S1)及癌旁>10 cm处黏膜组织(N1),并取50例肠镜检查为阴性结果的志愿者作为对照组,取粪便脱落细胞(S2)及正常结直肠黏膜组织(N2)。免疫组织化学检测Gankyrin蛋白在T及N1中的表达情况;分析Gankyrin蛋白表达与CRC肿瘤病理参数的关系及其与CRC预后的关系;蛋白质印迹法检测Gankyrin蛋白在T、S1、N1、S2及N2中的表达情况。结果 免疫组织化学检测提示T及N1中Gankyrin蛋白表达率分别为64%(64/100)及36%(36/100),T中Gankyrin蛋白的表达水平明显高于N1,差异有统计学意义(P<0.05);Gankyrin蛋白的表达量与CRC的TNM分期、淋巴结转移及肿瘤远处转移相关(均P<0.05);Gankyrin蛋白阳性患者术后5年生存时间显著低于Gankyrin蛋白阴性患者,差异有统计学意义(P<0.05);T中的Gankyrin蛋白表达量与S1中差异无统计学意义(P>0.05),而T、S1较N1、S2及N2中的Gankyrin蛋白表达量升高(P<0.05)。结论 Gankyrin蛋白在CRC中呈高表达,检测粪便脱落细胞中Gankyrin蛋白的表达对CRC的早期诊断具有重要意义。

关键词：  结直肠癌; 粪便脱落细胞; Gankyrin蛋白; 筛查

Abstract：

Objective To investigate the value of detecting Gankyrin protein expression in colorectal exfoliated cell and tissue cells for early diagnosis of colorectal cancer. Methods Samples contained colorectal cancer tissue(T), para-cancer tissues(N1), and exfoliated cell(S1) were collected in 100 CRC patients enrolled in Jiangmen Central Hospital from December 2013 to December 2014. Colonoscopic biopsy tissue (N2) and exfoliated cell (S2)from 50 volunteers who were negative by colonoscopy were collected as control. Immunohistochemical (IHC) staining was applied to analyze the correlations of Gankyrin expression with patho logical parameters and its influences on the prognosis. The Gankyrin expression in T, S1, N1, S2, N2 was detected by Western blot. Results Gankyrin IHC positive expression in cancer tissue was higher than para-cancer tissue significantly (64% vs. 36%, P＜0.05). Gankyrin positive expression in colorectal cancer tissues correlated with an advanced TNM stage, lymph node metastasis, and distal metastasis (P＜0.05).Patients with positive expression of Gankyrin exhibited a worse survival than those with negative ones (35.93% vs. 63.89%, P＜0.05). There was no significant difference between the Gankyrin expression in T and S1 (P＞0.05), while the Gankyrin expression in T and S1 was significantly higher than that in N1, S2, and N2(P＜0.05). Conclusion We find Gankyrin is overexpressed in colorectal cancer, which is correlated with poor prognosis. Detection of Gankyrin protein expression in feces shows a clinical value in the early diagnosis of colorectal cancer.

Key Words:  Colorectal cancer; Colorectal exfoliated cell; Gankyrin; Screening