大腸直腸癌病理特徵與分子表現相關性之探討

The correlation of the pathological characteristics and molecular expression of colorectal cancer

郭志鎰(Chih-Yi Kuo)

指導教授 ： 王朝鐘

中山醫學大學/醫學院/生化暨生物科技研究所/博士(2012年)

https://doi.org/10.6834/CSMU.2012.00171

摘要

在台灣地區大腸直腸癌的發生、死亡人數，每年呈快速增加，是所有癌症發生及死亡的第三位。95年發生人數更首次超越肝癌，成為我國癌症發生人數最多的癌症。大腸直腸癌具有高發生率及長時間進展的疾病自然史，超過95%的大腸直腸癌是從良性大腸瘜肉演變而來。從良性大腸瘜肉演變至大腸癌約需10-35年。雖然早期發現早期治療存活率高達80％以上。但目前並無發展出如乳癌，胃癌般將病患病理檢體以免疫染色檢測特定蛋白質的反應，配合細胞的生物特性、病理分期，以及臨床病徵等作不同的治療與預後考量的參考。因此，本研究自仁愛綜合醫院病理科組織庫，收集30名大腸直腸腫瘤及癌症患者之組織臘塊，以組織免疫染色法測定所有檢體在癌症hallmarks中之分子表現，並與病理分期，以及臨床病徵等條件做關連性分析統計。結果EP1表現，在臨床分期第三期以下的病人90%（10/11）有下調趨勢(down regulation ，T/N≦0.5)，VEGF在臨床分期第三期的病人有3/10，及內視鏡切除確診腺癌的病人有（4/6），均表現上調趨勢(up regulation ，T/N≧2)呈現顯著關係，CXCR4表現，在TNM腫瘤分期參數呈現顯著關係。HIF-1α表現與腫瘤分化和淋巴結轉移參數呈現顯著關係，β-catenine免疫染色呈現有93％（28/30）病人呈現(T/N 0.5-2) 無差異(no difference)以上反應，Ki-67免疫染色呈現有97％（29/30）病人呈現(T/N 0.5-2) 無差異(no difference)以上反應，更有60％（18/30）病人呈現(T/N≧2 )up regulation結果。我們的研究結果顯示HIF-1α，β-catenine，EP1，Ki-67及VEGF都具有大腸直腸癌治療與預後指標的效益。

關鍵字

大腸直腸癌

並列摘要

Colorectal cancer incidence and deaths rates rapidly increased in past years and now is the third place of all cancer incidence and mortality in the Taiwan region。 In 2006, it was the fist time that colorectal cancer incidence went beyond the liver cancer，and it now has the highest incidence of all cancers in Taiwan。Colorectal cancer has high incidence and long progress of the disease natural history； more than 95% of colorectal cancer evolved from a benign colorectal polyps。Evolving into cancer from benign colorectal polyps take about 10-35 years。Although the early detection of early treatment survival rate is as high as 80%， there is no development like breast cancer，gastric cancer，which detecting the patients’ pathologic specimens by immunohistochemical staining to identify specific protein reaction, along with the biological characteristics of the cells and disease stage，as well as clinical symptoms，etc，for different treatment and prognosis reference index。Therefore，this study from Jen-Ai General Hospital Department of Pathology tissue bank to collect 30 colorectal tumors and cancer patient tissue wax block for immunohistochemical staining determination of the molecular performance of all the specimens in the hallmarks of cancer，where and disease stage，as well as clinical symptoms and other conditions related statistical analysis。EP1 of performance results，the TMN-clinical stage less than III of patients (10/11) 90% down regulation (T/N≦0.5)，VEGF in the clinical stage of Phase III patients (3/10) ，and endoscopic resection confirmed adenocarcinoma patients (4/6) ， showed up regulation (T/N≧2) and showing a significant relationship，CXCR4 expression，TNM tumor staging parameters showing a significant relationship，HIF-1α and tumor differentiation and lymph node metastasis parameters showing a significant relationship，β-catenine immune staining showing (28/30) 93% of patients above (T/N 0.5-2) no difference response，Ki-67 immunostaining (29/30) 97% of patients showing above (T/N 0.5-2) no difference response，more (18/30) 60% of patients showing (T/N≧2) up regulation results。Our results show that HIF-1α,，β-catenine，EP1，Ki-67 and VEGF have the benefits of colorectal cancer treatment and prognostic indicators。

並列關鍵字

colorectal cancer

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