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目的 探讨大肠癌分子生物学特征与预后关系。方法 通过我院近年来对大肠癌病人的DI,SPF,PI及相关基因等检测与生存率关系判定其预后指标。结果 DNA二倍体肿瘤五年生存率明显高于非二倍体,并表明DI,SPF,PI能反应肿瘤生物学特征,可作为判定预后指标。相关基因p12,p53,nm23表达与预后具有相关性,可为预后提供一定的参考。p16在照射后其基因产物表达水平的变化与3年生存率无关,与5年生存率之间存在密切相关。不同大体分型之间,淋巴结的转移与否之间,p16基因产物表达水平在照射前后的变化均存在显著差异。照射后的p53、rasp21、及nm23基因表达产物分别与p16基因产物在照射前后的变化密切相关。大肠癌组织具有依赖性激素的特征,ER(+)/PR(+)生存期高于ER(-)/PR(-),对判定预后有一定意义。结论 大肠癌分子生物学检测虽然补充了临床病理分期的不足,但是能否为预后提供独立的信息还尚存争议。对这些指标还需进一步研究,作出真实客观的评价。
Objective To investigate the relationship between molecular biology and prognosis of colorectal cancer. Methods In our hospital in recent years, the prognosis of patients with colorectal cancer, DI, SPF, PI and related gene detection and survival rates were determined. Results The five-year survival rates of DNA diploid tumors were significantly higher than those of non-diploid ones, indicating that DI, SPF and PI could reflect the biological characteristics of tumors and could be used as a prognostic indicator. Related genes p12, p53, nm23 expression and prognosis are related, can provide some reference for the prognosis. The gene expression level of p16 after irradiation has nothing to do with 3-year survival rate, and 5-year survival rate is closely related. There was a significant difference in the expression level of p16 gene product between different general types and lymph node metastasis before and after irradiation. The expressions of p53, rasp21 and nm23 after irradiation were closely related to the changes of p16 gene product before and after irradiation respectively. Colorectal cancer has the characteristics of dependent hormone, and the survival rate of ER (+) / PR (+) is higher than that of ER (-) / PR (-). Conclusion Although molecular biology tests of colorectal cancer have supplemented the lack of clinical staging, it remains controversial whether it can provide independent information for prognosis. These indicators need further study to make a true and objective evaluation.