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1、Smad4表达缺失与结直肠癌肝转移的相关性研究9陈小会[通信作者]陈小会,Email:chenxiaoh2007@163.com,卢启明（300232天津,天津市第一医院1;730000兰州,甘肃省人民医院消化科2）[摘要]目的探讨Smad4与结直肠癌肝转移的相关性。方法通过免疫组化方法检测79例结直肠癌组织和20例癌旁正常组织中Smad4的表达,选择性别、肿瘤部位、肿瘤大小、肿瘤分化程度、淋巴结转移、大体分型、术前血清CEA水平和Smad4表达等8个可能影响肝转移的因素,用χ2和Logistic回归进行单因素和多因素分析(SPSS1
2、9.0统计软件)。结果Smad4在结直肠癌组织中表达减少,阴性表达率为72.2%(57/79),在结直肠正常组织中阴性表达率为5.0%(1/20),差异有统计学意义(P<0.01)。单因素分析显示,肿瘤分化程度、淋巴结转移、术前血清CEA和Smad4蛋白表达与肝转移有相关性(P<0.05)；多因素分析显示,淋巴结转移、术前血清CEA水平和Smad4表达与肝转移相关,是结直肠癌肝转移的独立因素(OR=6.059,3.723,0.170,P<0.05)。结论Smad4的表达缺失与结直肠癌肝转移明显相关,可作为一个新的预测结直肠癌肝转移的生
3、物指标。淋巴结转移、术前血清CEA水平和Smad4表达是结直肠癌肝转移的独立的危险因素。[关键词]结直肠癌;免疫组织化学;肝转移;Smad4[中图法分类号]R735.34;R730.23;R730.6[文献标志码]ATheresearchonthecorrelationbetweennegativeexpressionofSmad4andlivermetastasisofcolorectalcarcinoma ChenXiaohui1,LuQiming2(1FirstHospitalofTianjinCity,Tianjin,3002
4、32;2DepartmentofGastroenterology,GansuProvincePeople’sHospital,Lanzhou,GansuProvince，730000,China)[Abstract]ObjectiveToexplorethecorrelationbetweenabsenceofexpressionofSmad4andlivermetastasisofcolorectalcarcinoma.MethodsTheexpressionofSmad4in79casesofcolorectalcarcinoma
5、tissueand20casesofnormalcolorectaltissuearoundthefociweredetectedbySPimmunohistochemistry.Eightfactorsthatmayaffectthelivermetastasiswereselected,including9sex,localizationoftumor,tumorsize,differentiationgrade,pathologicallymphnodemetastasis,grosstumortype,preoperative
6、levelofserumCEA,expressionofSmad4．χ2testforsinglefactoranalysisandLogisticRegressionformultifactoranalysiswereadoptedbySPSS19.0program.ResultsTheexpressionofSmad4incolorectalcarcinomatissuewaslow,72.2%(57/79)fornegativeexpressionofSmad4,and5.0%(1/20)fornegativeexpressio
7、nofSmad4innormalcolorectaltissue,thedifferencewasstatisticallysignificant(P<0.01).Differentiationgrade,pathologicallymphnodemetastasis,preoperativelevelofserumCEAandexpressionofSmad4wererelatedwithlivermetastasisbysinglefactoranalysis(P<0.05).Onlypathologicallymphnodeme
8、tastasis,preoperativelevelofserumCEAandexpressionofSmad4wererelatedwithlivermetastasisbymultifactoranalysis,wh
