【摘要】 目的了解结直肠癌、腺瘤患者结直肠黏膜是否存在慢性炎症状态,并通过检测炎症因子NF-κB、COX-2的表达,了解炎症与结直肠肿瘤发病的关系。方法根据结肠镜检查及病理结果分三组:(1)结直肠癌组31例;(2)结直肠腺瘤组29例;(3)正常对照组18例。取肿瘤组织及距肿瘤5cm处正常黏膜,对照组取正常黏膜组织制作标本切片,显微镜下比较各组组织淋巴细胞浸润程度及腺体形态变化情况;采用免疫组化方法比较炎症因子NF-κB、COX-2的表达水平。结果(1)淋巴细胞浸润程度根据严重程度分为四级,1～4级在结直肠癌旁黏膜中分别占6.5%、29%、51.6%、12.9%,在腺瘤旁黏膜中分别为31%、41.3%、27.6%、0%,在正常黏膜中分别为66.7%、16.7%、16.7%、0%,癌旁黏膜、腺瘤旁黏膜淋巴细胞浸润程度均显著高于正常结肠黏膜(P<0.001,P<0.05)。(2)结直肠癌旁黏膜腺体变异率(61.3%)显著高于正常结肠黏膜组织(27.8%)(P<0.05),腺瘤旁黏膜腺体变异率(44.8%)与正常结肠黏膜无明显差异(P=0.37)。(3)依表达程度由(-)至(+++)四级计算,NF-κB的表达率在结直肠癌组织中分别为0%、22.6%、48.4%、39%,癌旁黏膜中为51.6%、45.2%、3.2%、0%,腺瘤中为13.8%、31%、48.3%、6.9%,腺瘤旁黏膜中为51.8%、44.8%、3.4%、0%,在正常黏膜中为22.2%、77.8%、0%、0%,结直肠癌及腺瘤组织NF-κB的表达水平分别高于病变旁黏膜及正常黏膜(P<0.001)。(4)COX-2的表达率按(-)至(+++)四级计算在结直肠癌组织中分别为12.9%、32.3%、45.2%、9.7%,癌旁黏膜中为22.6%、41.9%、35.5%、0%,腺瘤中为0%、27.6%、72.4%、0%,腺瘤旁黏膜中为24.1%、48.3%、27.6%、0%,在正常黏膜中为5.6%、94.4%、0%、0%,结直肠癌COX-2的表达水平显著高于癌旁黏膜(P<0.05)及正常黏膜(P<0.01),腺瘤组织COX-2的表达水平亦显著高于腺瘤旁黏膜及正常黏膜(P<0.001)。结论结直肠癌、腺瘤患者结直肠粘膜存在慢性炎症,表现为淋巴细胞浸润、腺体变异。NF-κB、COX-2在结直肠癌、腺瘤组织中表达水平较高。更多还原

【Abstract】 Objective: To understand whether the chronic inflammatory state exist in the colorectal mucosa of patients with colorectal carcinomas and adenomas. To study the relationship between the inflammatory factors and the oncogenesis of colorectal tumors by searching the contribution of NF-κB and COX-2. Methods: The patients were divided into three groups:the patients with colorectal cancers, the patients with adenoma and the control group. Choose the tissue of the neoplasm, the mucosa close to the neoplasm and the control mucosa, and then compare the infiltrative degree of the lymphocyte and the morphous of glands between the groups. Immunohistochemistry method was undertaken to determine the expression of NF-κB p65 and COX-2 in the tissue of the groups. Results: (1)The infiltrative degree of the lymphocyte, divided into 4 grades from 1 to 4, is respectively 6.5%,29%,51.6%,12.9% in the mucosa close to cancers; 31%,41.3%,27.6%,0% in the mucosa close to adenomas;66.7%,16.7%,16.7%,0% in the control mucosa. The infiltrative degree of the lymphocyte in the mucosa close to cancers and adenomas are higher significantly than the ones in the control mucosa (P<0.001, P<0.05). (2)The aberration rate of glands’morphous in the mucosa close to the cancers(61.3%) is higher than the one in the controls (27.8%) (P<0.05). There is no significant difference between the aberration rate of glands’ morphous in the mucosa close to the adenomas and the controls(P>0.05). (3) NF-κB p65 expression, divided into 4 grades from (-) to (+++), is respectively 0%,22.6%,48.4%,39% in cancers;51.6%,45.2%,3.2%,0% in mucosa close to the cancers;13.8%, 31%,48.3%,6.9% in adenomas;51.8%,44.8%,3.4%,0% in mucosa close to the adenoma;22.2%,77.8%,0%,0% in control mucosa;the expression of NF- κB p65 in colorectal cancers and adenomas are higher than the ones of the mucosa close to theneoplasm (P<0.001) and control mucosa (P<0.001). (4)The expression of COX-2 is respectively 12.9%,32.3%,45.2%,9.7% in cancers; 22.6%,41.9%,35.5%,0% in mucosa close to the cancers;0%,27.6%,72.4%,0% in adenomas;24.1%,48.3%,27.6%,0% in mucosa close to the adenoma; 5.6%,94.4%,0%,0% in normal colonic mucosa. The expression of COX-2 in colorectal cancers is higher significantly than the ones in the mucosa close to the cancers (P<0.05) and control mucosa(P<0.01). The expression of COX-2 in adenomas is higher significantly than the ones in the mucosa close to the adenomas (P<0.001) and control mucosa (P<0.001). Conclusions:Chronic inflammation is present in patients’ colorectal mucosa with colorectal cancers and adenomas, which consists of infiltration of lymphocyte, aberration of glands’ morphous and so on. NF-κB and cox-2 express highly in the colorectal cancers and adenomas.更多还原