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目的探讨CXCR4和MMP-9表达及临床病理因素与结直肠癌根治术后早期复发的关系。方法应用免疫组化SP法检测同期结直肠癌根治术后早期复发患者40例(复发时间为术后3个月～1年)与3年以上未复发者30例的癌组织中CXCR4和MMP-9表达水平,应用χ2检验、logistic回归分析统计学方法分析二者及临床病理因素与结直肠癌早期复发的关系。结果早期复发组与未复发组结直肠癌组织中CXCR4呈阳性表达率分别为75.0%(30/40)和43.3%(13/30),两组比较差异具统计学意义(P<0.05)。早期复发组与未复发组癌组织中MMP-9呈阳性表达率分别为65.0%(26/40)和40.0%(12/30),两组比较差异具统计学意义(P<0.05)。结直肠癌患者的肿瘤部位(P=0.004,β为1.957,OR值为7.079)、肠壁浸润深度(P=0.047,β为0.889,OR值为2.434)和CXCR4表达(P=0.008,β为1.855,OR值为6.391)是术后早期复发的危险因素。其中肿瘤部位和CX-CR4表达是影响术后早期复发最重要因素。而术后辅助化疗(P=0.026,β为-2.440,OR值为0.087)是早期复发的保护性因素。结论 CXCR4的异常表达与结直肠癌根治术后早期复发密切相关,提示其可能对结直肠癌术后早期复发的发生和发展有重要作用。
Objective To investigate the relationship between the expression of CXCR4 and MMP-9 and clinicopathological factors and early recurrence of colorectal cancer after radical operation. Methods SP immunohistochemical method was used to detect the expression of CXCR4 and MMP-9 in 40 patients with early recurrence of colorectal cancer after radical resection (recurrence time from 3 months to 1 year) and 30 cases without recurrence of colorectal cancer 9 expression levels, using χ2 test, logistic regression analysis of statistical methods to analyze the relationship between the two and clinicopathological factors and early recurrence of colorectal cancer. Results The positive rates of CXCR4 expression in early recurrence group and non-recurrence group were 75.0% (30/40) and 43.3% (13/30), respectively. The difference between the two groups was statistically significant (P <0.05). The positive expression rates of MMP-9 in early recurrence group and non-recurrence group were 65.0% (26/40) and 40.0% (12/30), respectively. The difference between the two groups was statistically significant (P <0.05). The tumor location (P = 0.004, β = 1.957, OR = 7.079), depth of intestinal wall invasion (P = 0.047, β = 0.889, OR = 2.434) and CXCR4 expression in colorectal cancer patients (P = 0.008, 1.855, OR 6.391) is a risk factor for early postoperative recurrence. Which tumor location and CX-CR4 expression is the most important factor affecting the early postoperative recurrence. Postoperative adjuvant chemotherapy (P = 0.026, β = -2.440, OR = 0.087) was a protective factor for early relapse. Conclusion The abnormal expression of CXCR4 is closely related to the early recurrence of colorectal cancer after radical operation, suggesting that it may play an important role in the occurrence and development of early postoperative recurrence of colorectal cancer.