李延辉　谢敏如　叶仕英　康举龄　夏明汗.广东省东莞市石碣医院病理科，广东东莞　590；.广东省东莞市石碣医院科教科，广东东莞　590；.广东省广州市暨南大学附属一院病理科，广东东莞　50000

结肠癌及癌前病变中APRIL和caspase-3蛋白的表达及其作用

李延辉1谢敏如1叶仕英2康举龄3夏明汗3
1.广东省东莞市石碣医院病理科，广东东莞523290；2.广东省东莞市石碣医院科教科，广东东莞523290；3.广东省广州市暨南大学附属一院病理科，广东东莞510000

目的探讨结肠癌及癌前病变中增殖诱导配体（APRIL）和caspase-3蛋白的表达及其作用机制。方法收集2009年8月～2015年4月东莞市石碣医院和广州市暨南大学附属一院病理科结肠癌切除及结肠镜活检标本共190例，其中正常结肠黏膜25例，结肠腺瘤伴轻、中、重度不典型增生各25例，结肠癌40例。采用SP法免疫组化方法检测各组黏膜中APRIL和caspase-3蛋白表达情况。结果 在正常结肠黏膜、结肠腺瘤伴轻度不典型增生、伴中度不典型增生、伴重度不典型增生和结肠癌中，APRIL的表达呈逐渐增高趋势，caspase-3的表达呈递减趋势，差异有统计学意义（χ2=21.49、12.79，P＜0.05）。APRIL的阳性表达与结肠癌患者的组织分化、淋巴结转移以及浸润程度有关（P＜0.05），而caspase-3的阳性表达与结肠癌患者的肿瘤淋巴结转移（TNM）分期、淋巴结转移有关（P＜0.05）。经Spearman等级相关分析，40例结肠癌中APRIL和caspase-3表达呈明显的负相关性（r=-0.512，P＜0.05）。结论APRIL的过表达和caspase-3的表达下降可能在结肠癌的发生发展过程中发挥重要作用，两者表达具有一定相关性。

结肠癌；结肠癌前病变；APRIL；caspase-3

［Abstract］Objective To observe the expressions of APRIL and caspase-3 in colon carcinoma and colon precancerous lesion，and to study the role of APRIL and caspase-3.Methods 190 cases of colon cancer resection and colonoscopy biopsy specimens in General Department of Dongguan Shijie Hospital and the First Hospital of Jinan University from August 2009 to April 2015 were collected，including 25 cases of normal colon mucosa，75 cases of colon precancerous lesion and 40 cases of colon carcinoma.The immune histochemical staining was used to detect the expressions of APRIL and caspase-3 in 25 cases of normal colon mucosa，75 cases of colon precancerous lesion and 40 cases of coloncarcinoma.Results The expression of APRIL increased from normal colon mucosa，colon adenoma with mild dysplasia，with moderate dysplasia，with severe dysplasia to colon gastric carcinoma（χ2=21.49，P＜0.05）and the expression of caspase-3 decreased from normal colon mucosa，colon adenoma with mild dysplasia，with moderate dysplasia，with severe dysplasia to colon carcinoma（χ2=12.79，P＜0.05）.The positive expression of APRIL were related to tissue differentiation，lymph node metastasis and the depth of invasion.The positive expression of caspase-3 were related to TNM stage and lymph node metastasis.The expression rate of APRIL was negatively correlated with the expression rate of caspase-3（r=-0.512，P＜0.05）.Conclusion The over-expression APRIL and the lose-expression caspase-3 may play the important role in the development of colon carcinoma and it's negative relationship between APRIL and caspase-3.

［Key words］Colon carcinoma；Colon precancerous lesions；APRIL；Caspase-3

近年调查研究发现，细胞的增殖和凋亡平衡紊乱在结肠癌的发生、发展过程中发挥了十分重要的作用［1-3］。……