南方医科大学学报 ›› 2013, Vol. 33 ›› Issue (07): 972-.

• • 上一篇    下一篇

Lgr5和CD44在肠息肉和结直肠癌中的表达及意义

柴宁莉,张文成,王艳敏,周昭涛,张艳娥,刘红艳,万军,覃金华,王术勇,王韫芳,裴雪涛,吴本俨,令狐恩强   

  • 出版日期:2013-07-20 发布日期:2013-07-20

Lgr5 and CD44 expressions in different types of intestinal polyps and colorectal cancer

  • Online:2013-07-20 Published:2013-07-20

摘要: 目的探讨不同病理分型肠息肉与肿瘤发生相关的干细胞标志Lgr5和CD44的表达及其对息肉癌变的临床预测意义。方
法经结肠镜活检获取结肠直肠息肉、腺瘤和癌组织145例,进行病理检测分型;应用免疫组化方法检测不同病理类型标本中肿
瘤干细胞标志Lgr5 和CD44 的表达,分析比较其与结、直癌的发生和预后的关系。结果CD44 在结肠癌组织中的表达率为
95.65%,显著高于正常粘膜5%、炎性增生性息肉22.58%、管状腺瘤性息肉55.26%及绒毛状息肉75.76%(P<0.05)。Lgr5在大肠
癌组织中的表达高达95.65%(22/23),显著高于正常粘膜(无表达)和炎性增生息肉16.12%(P<0.05),而在管状腺瘤和绒毛状腺
瘤中表达分别为86.84%(33/38)和93.94%(31/33),与大肠癌相比,两两差异不具有统计学意义(P>0.05)。相关性分析结果显
示,CD44、Lgr5的表达强度与肠息肉癌变进展均呈正相关(rs=0.69377,P<0.0001;rs=0.81637,P<0.0001)。结论Lgr5和CD44在
大肠癌癌组织中高表达,它们的高表达与临床和病理的特征具有显著相关性;Lgr5和CD44的表达是区别大肠癌癌组织与正常
肠粘膜组织的显著特点;与CD44相比,Lgr5 表达与息肉癌变具有较强相关性,联合检测Lgr5 与CD44在肠道早期病变诊断、尤
其是肠息肉癌变预测中具有重要意义。

Abstract: Objective To study the expression of tumorigenesis-related stem cell markers Lgr5 and CD44 in different
pathological types of intestinal polyps and their clinical significance in predicting tumorigenesis. Methods A total of 145 cases
of colorectal polyps, adenomas and cancer tissues were obtained by colonoscopy biopsy. Immunohistochemistry was
employed to detect the expression of Lgr5 and CD44 to analyze their relationship with the occurrence and prognosis of colon
and rectal cancer. Results The expression of CD44 in colon cancer tissue was 95.65%, significantly higher than that in normal
mucosa (5%), inflammatory hyperplastic polyps (22.58%), tubular adenomatous polyps (55.26%) and villous polyps (75.76%)
(P<0.05). The expression of Lgr5 in colorectal cancer was up to 95.65% while negative in normal colorectal tissue and was
16.12% in inflammatory hyperplastic tissues (P<0.05). The expression rate of Lgr5 was 86.84% in tubular adenoma and 93.94%
in villous polyps, both comparable with that in colon cancer (P>0.05). Correlation analysis indicated that the expression of
CD44 and Lgr5 were positively correlated with the progression of intestinal polyp tumorigenesis (rs=0.69377, P<0.0001; rs=
0.81637, P<0.0001). Conclusion Lgr5 and CD44 are highly expressed in colorectal cancer tissues in close correlation with the
clinical and pathological features. The expression profiles of Lgr5 and CD44 represent a distinct feature to differentiate
colorectal cancer from normal intestinal mucosa. Lgr5 is more closely correlated with tumor progression of polyps than CD44.
This means detecting of the expression of Lgr 5 together with CD44 is important and necessary in clinical diagnosis of patients
with early stage colorectal diseases such as polyps and their canceration.