摘要目的 探讨肿瘤干细胞调节基因发状分裂相关增强子1( Hes1)在结直肠癌中的表达及其临床病理特征与肿瘤预后之间的关系.方法 前瞻性收集2004年8月至2006年9月,在南京中医药大学第三附属医院全国肛肠医疗中心行手术治疗的结直肠癌患者,146例结直肠癌患者建立队列,男84例(57.5％)、女62例(42.5％),平均年龄(61±11)岁.对患者肿瘤标本建立组织芯片并采用免疫组织化学方法检测Hes1基因表达,对患者随访并对相关资料进行统计学处理.结果 在146例结直肠癌标本中,Hes1阴性或弱阳性表达占8％ (12/146),阳性(+)为77％ (112/146),而阳性(++)为15％ (22/146)；单因素分析结果显示Hes1基因表达与分化程度有关(P =0.033).134例成功随方,随访率91.8％,平均随访时间(42±13)个月,以Kaplan-Meier生存曲线估计该组患者总1年生存率93％ (136/146)、总3年生存率74％( 108/146)、总5年生存率67％ (98/146).肿瘤的预后与TNM分期和病理学类型均相关(均P=0.000),与Hes1基因表达不相关(P =0.267).结论 肿瘤于细胞调节基因Hes1表达与分化程度有关,多因素分析显示Hes1与生存不相关.

abstractsObjective To explore the roles of hairy enhancer of split 1 ( Hes1 ) gene in colorectal cancer and analyze its clinical significance.Methods A total of 146 cases with colorectal cancer at our hospital were collected prospectively and followed up.There were 84 males and 62 females with an average age of (61 ± 11 ) years old.Tissue microarray was prepared and the expression of Notch signal genes were detected by immunohistochemical staining.Results The differential expressions of Hesl were significant among various types [ negative or weakly positive:8％ ( 12/146),positive( + ):77％ ( 112/146 ),positive ( + + ):15％ (22/146) ].Among all,134 were followed up successfully for an average duration of (42 ±13) months.According to the Kaplan-Meier life curve,the overall 1,3 and 5-year survival rates were 93％( 136/146),74％ (108/146) and 67％ (98/146) respectively.The long-term survival rate was correlated with TN M stage and pathological types ( all P =0.000),but not with Hesl ( P =0.267).Conclusion The expression of Hesl is correlated with pathological types and differentiation types.However the long-term survival rate is not correlated with its expression.