目的 探讨结直肠癌肿瘤组织中跨膜丝氨酸蛋白酶4(TMPRSS4)、间质表皮转化因子(c-Met)、驱动蛋白家族成员18A(KIF18A)表达水平与其病理特性和生存状态的关系.方法 选取该院于2015年3月至2017年6月确诊的102例结直肠癌患者作为研究对象,比较癌变组织和癌旁组织TMPRSS4、c-Met阳性率及KIF18A水平的差异,不同病理状态及生存状态患者的TMPRSS4、c-Met阳性率及KIF18A水平的差异,分析患者的病理状态及生存状态与TMPRSS4、c-Met阳性率和KIF18A水平的相关性.结果 癌变组织TM-PRSS4、c-Met阳性率及KIF18A水平明显高于癌旁组织(P<0.05);不同性别、年龄患者TMPRSS4、c-Met阳性率及KIF18A水平比较差异均无统计学意义(P>0.05),而不同病程、TNM分期、临床分型患者之间比较差异有统计学意义(P<0.05);通过对患者的随访,生存患者61例,死亡患者41例,生存组TMPRSS4、c-Met阳性率及KIF18A水平明显低于死亡组(P<0.05);患者的TNM分期、临床分型、病程及生存状态与TM-PRSS4、c-Met阳性率及KIF18A的水平呈正相关(r=0.165～0.998,P<0.05).结论 结直肠癌肿瘤组织中TMPRSS4、c-Met阳性率及KIF18A水平与其病理特性和生存状态存在一定的相关性,可作为结直肠癌患者诊断辅助参考之一.

Objective:To explore the clinicopathological characteristics and prognosis of colorectal cancer with liver and lung metastases according to different T stage.Methods:The information of 2 602 patients with colorectal cancer with liver and lung metastases registered in the surveillance, epidemiology and end results (SEER) database from 2010 to 2015 was collected. All the patients were divided into three groups according to T stage: T0/T1 group ( n=545), T2/T3 group ( n=1 138), and T4 group ( n=919). The clinicopathological characteristics (including age, sex, race, primary tumor site, histology, differential stage, T/N stage, distant metastatic site, carcinoembryonic antigen, surgery, and overall survival) were compared across the three groups and the impact of T stage on the overall survival was detected by Kaplan-Meier method and COX logistical analysis. Results:The proportion of N2 in T0/T1 group was significantly lower than those in T2/T3 group and T4 group [3.5% (19/545) vs. 29.3% (333/1 138), χ2=379.911, P<0.05; 3.5% (19/545) vs. 32.4% (298/919), χ2=379.911, P<0.05]. The proportion of rectum location in T4 group was significantly lower than those in T0/T1 group and T2/T3 group [18.6% (167/899) vs. 32.8% (165/503), χ2=64.569, P<0.05; 18.6% (167/899) vs. 33.9% (382/1 127), χ2=64.569, P<0.05]. Among the three groups, the proportion of grade Ⅳ in T0/T1 group was the lowest, and the proportion of grade Ⅲ and Ⅳ in T4 group was the highest. COX logistical analysis indicated that T0/T1 group [hazard ratio ( HR)=1.130, 95% confidence interval ( CI): 1.001-1.275, P<0.05] and T4 group [ HR=1.190, 95% CI: 1.085-1.305, P<0.01] showed a significantly poorer prognosis compared with T2/T3 group. Conclusion:Patients with colorectal cancer with liver and lung metastases in the different T stage presented significantly different clinicopathological characteristics and prognosis, especially for T0/T1 stage that has lower proportion of N2 and poorer prognosis.