[预测结肠憩室患者发生结直肠癌的临床、内窥镜、实验室和免疫形态学参数]。

Pub Date : 2024-09-14 DOI:10.26442/00403660.2024.08.202818
A А Svistunov, M A Osadchuk, E D Mironova, I S Krylova
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引用次数: 0

摘要

目的:明确临床、内镜、实验室和免疫形态学参数在预测结肠憩室疾病(DDC)患者结直肠癌(CRC)的发生和病程中的作用:研究人员将 175 名 DDC 患者分为 3 组:第 1 组--85 名 DDC 患者;第 2 组--45 名 DDC 合并腺瘤性息肉(AP)患者;第 3 组--45 名 DDC 合并已确诊 CRC(I 期或 II 期)患者。对照组由 30 名身体健康的人组成。对患者和健康人的检查采用单一方案:临床、实验室、仪器数据和免疫形态学研究方法[使用p53(mAb克隆DO-7,产品编号:PA0057,徕卡生物系统公司,徕卡邦德III)和Ki-67(Ab16667,Abcam,英国)的一元抗体]:结果:在 DDC 和 CRC 患者的主要主诉中,便秘比 DDC 和 DDC 伴 AP 患者更常见(P0.05)。在 DDC 和结直肠肿瘤患者中,与 DDC 组相比,粪便隐血阳性反应更常见(P0.05)。与 DDC 组相比,DDC 伴 AP 和 CRC 患者血浆中葡萄糖和胆固醇水平以及体重指数更高(P0.05)。与未患结直肠肿瘤的 DDC 患者相比,DDC 合并 AP 和 CRC 患者的 Ki-67 和 p53 表达水平更高(P0.05)。同时,在 DDC 合并 CRC 的患者中,Ki-67 和 p53 的表达水平高于 DDC 合并 AP 的患者(P0.05)。DDC 合并 AP 和 CRC 患者的血糖、血浆胆固醇和体重指数水平高于单纯 DDC 患者组(P0.05)。值得注意的是,结肠粘膜中 Ki-67 和 p53 的测定结果应被视为 DDC 患者发展为 CRC 的重要预后指标。
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[Clinical, endoscopic, laboratory and immunomorphological parameters in predicting the occurrence of colorectal cancer in patients with diverticular disease of the colon].

Aim: To define the role of clinical, endoscopic, laboratory and immunomorphological parameters in predicting the occurrence and course of colorectal cancer (CRC) in patients with diverticular disease of the colon (DDC).

Materials and methods: One hundred and seventy five people with DDC were examined, divided into 3 groups: group 1 - 85 patients with DDC; group 2 - 45 with DDC in combination with adenomatous polyps (AP); 3rd group - 45 with DDC with established CRC (I or II stage). The control group consisted of 30 practically healthy people. Patients and healthy people were examined according to a single program: clinical, laboratory, instrumental data and immunomorphological research methods [use of primary antibodies to p53 (mAb clone DO-7 product no. PA0057, Leica Biosystems, Leica Bond III) and Ki-67 (Ab16667, Abcam, UK)].

Results: Among the main complaints in patients with DDC and CRC, constipation was more common than in patients with DDC and DDC with AP (p<0.05). In patients with DDC and colorectal neoplasia, a positive reaction to occult blood in the feces was more often verified, compared with the group with DDC (p<0.05). Higher levels of glucose and cholesterol in blood plasma, as well as body mass index were found in patients with DDC with AP and CRC, compared with the DDC group (p<0.05). A higher level of expression of Ki-67 and p53 was found in patients with DDC combined with AP and CRC, compared with patients with DDC without colorectal neoplasia (p<0.05). At the same time, in patients with DDC with CRC, the expression level of Ki-67 and p53 was higher than in patients with DDC with AP (p<0.05) Conclusion. In patients with DDC combined with AP and CRC, higher levels of glucose, plasma cholesterol, as well as body mass index were observed compared to the group of patients with DDC alone (p<0.05). Of note, the results of the determination of Ki-67 and p53 in the mucous membrane of the colon should be considered important prognostic markers for the development of CRC in patients with DDC.

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