不同组织学类型结直肠腺癌的临床病理和免疫组织化学特征
| 作者: |
1裴笑月,
1胡波,
1吕玲,
1李晓慧
1 大连大学附属新华医院病理科，辽宁 大连 116021 |
| 通讯: |
胡波
Email: hubo478@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2020.08.003 |
摘要
目的：探讨不同组织学类型结直肠腺癌的临床病理及免疫组织化学特征。方法：收集临床资料完善的结直肠腺癌292例，免疫组织化学SP法检测所有肿瘤组织中突变型p53、错配修复蛋白及EGFR蛋白的表达，统计分析所有病例的临床病理参数及3种蛋白质的表达意义。结果：292例结直肠腺癌中，伴微乳头状结构的腺癌11例，黏液腺癌19例，管状腺癌262例。临床病理特征上，伴微乳头状结构腺癌的脉管侵犯程度显著高于管状腺癌和黏液腺癌(P<0.05)。伴微乳头状结构腺癌的神经侵犯程度及淋巴结转移率均显著高于管状腺癌(P<0.05)。伴微乳头状结构腺癌的III期比例显著多于管状腺癌(P<0.05)。伴微乳头状结构腺癌和管状腺癌在直肠部位的比例显著多于黏液腺癌(P<0.05)。管状腺癌的发生年龄显著高于黏液腺癌(P<0.05)。免疫组织化学特征上，突变型p53在伴微乳头状结构腺癌及管状腺癌表达的阳性率均显著高于黏液腺癌(P<0.05)。EGFR蛋白在管状腺癌表达的阳性率显著高于黏液腺癌(P<0.05)。错配修复蛋白的阳性表达与3种结直肠癌类型均无明显相关性(P>0.05)。结论：不同亚型结直肠腺癌中存在肿瘤的异质性，正确识别结直肠腺癌的组织学类型有助于肿瘤个体化治疗及预后的评估。
关键词：
结直肠腺癌；伴微乳头状结构的腺癌；管状腺癌；黏液腺癌
Clinicopathological and immunohistochemical features in different histological types of colorectal carcinoma
CorrespondingAuthor: HU Bo Email: hubo478@126.com
DOI: 10.3978/j.issn.2095-6959.2020.08.003
Abstract
Objective: To investigate the clinicopathological and immunohistochemical characteristics of different histological types of colorectal carcinoma. Methods: A total of 292 cases of colorectal carcinoma with complete clinical data were collected. The protein expression of p53, mismatch repair protein and EGFR in all tumor tissues was detected by immunohistochemical method and their clinicopathological and immunohistochemical features was analyzed. Results: Among the 292 cases of colorectal adenocarcinoma, 11 cases were adenocarcinoma with micropapillary structure, 19 cases were mucinous adenocarcinoma, and 262 cases were tubular adenocarcinoma. The degree of vascular invasion with micropapillary adenocarcinoma was significantly higher than that of tubular adenocarcinoma and mucinous adenocarcinoma (P<0.05). The degree of nerve invasion and lymph node metastasis of adenocarcinoma with micropapillary structure were significantly higher than those of tubular adenocarcinoma (P<0.05). The III period ratio of adenocarcinoma with micropapillary structure was significantly more than that of the tubular adenocarcinoma (P<0.05). The proportion of micropapillary adenocarcinoma and tubular adenocarcinoma in the rectum was significantly more than that of mucinous adenocarcinoma (P<0.05). The age of tubular adenocarcinoma was significantly higher than that of mucinous adenocarcinoma (P<0.05). Immunohistochemical characteristics showed that the positive rates of p53 expression in adenocarcinoma with micropapillary structure and tubular adenocarcinoma were significantly higher than those in mucinous adenocarcinoma (P<0.05). The expression of EGFR protein in tubular adenocarcinoma was significantly higher than that in mucinous adenocarcinoma (P<0.05). The expression of mismatch repair protein had no relationship with the three types of colorectal cancer (P>0.05). Conclusion: There is tumor heterogeneity in different subtypes of colorectal carcinoma. Correctly identifying the histological type of colorectal adenocarcinoma is helpful to the individualized treatment and prognosis evaluation of the tumor.
Keywords：
colorectal carcinoma; micropapillary adencocarcinoma; tubular adenocarcinoma; mucinous adenocarcinoma