| 摘要: |
| ［摘要］ 目的 分析直肠癌组织和术前循环肿瘤细胞（CTCs）中立即早期反应3（IER3）的表达情况，并研究其与患者临床病理特征的关联性。方法 招募广西壮族自治区人民医院2017年1月至2019年1月收治的直肠癌患者42例，健康体检者42名。患者于术前1 d采集外周血5 mL（健康体检者于体检时采集），通过原位杂交技术检测术前CTCs水平及CTCs中IER3 mRNA的表达情况，并进行CTCs分型。采用实时荧光定量聚合酶链反应（qRT-PCR）检测直肠癌组织及癌旁组织中IER3 mRNA表达水平，采用免疫组化染色检测组织IER3蛋白表达情况。分析直肠癌组织IER3 mRNA表达水平与患者临床病理特征的关联性。分析直肠癌组织IER3的mRNA和蛋白表达与CTCs水平的相关性。分析CTCs水平以及IER3 mRNA阳性表达的CTCs水平与患者临床病理特征的关联性。随访截至2023年12月31日，分析直肠癌组织IER3 mRNA和蛋白表达水平与患者生存预后的关联性。结果 直肠癌组织IER3 mRNA表达水平及IER3蛋白阳性表达率显著高于癌旁组织（P<0.05）。健康体检者中均未检测到CTCs。直肠癌患者术前CTCs检出率为92.86%（39/42），其中29例患者CTCs中存在IER3 mRNA表达，表达率为74.36%（29/39）。不同类型CTCs的IER3 mRNA表达情况无显著差异（P>0.05）。Spearman秩相关分析结果显示，直肠癌组织IER3 mRNA表达水平与总CTCs水平呈负相关（rs=-0.317，P=0.041）。直肠癌组织IER3蛋白表达情况与总CTCs、混合型CTCs水平具有显著关联（P<0.05）。CTCs水平与患者临床病理特征无显著关联（P>0.05）。IER3 mRNA阳性表达的间质型CTCs水平与患者N分期、T分期、TNM分期有显著关联（P<0.05）。IER3 mRNA阳性表达的上皮型CTCs、混合型CTCs及总CTCs水平与患者临床病理特征均无显著关联（P>0.05）。直肠癌组织IER3蛋白及mRNA表达情况与患者生存预后无显著关联（P>0.05）。结论 IER3在直肠癌组织中呈高表达，且与肿瘤侵袭转移相关病理特征及CTCs的数量、亚型存在关联性。 |
| 关键词: 直肠癌 循环肿瘤细胞 立即早期反应3 免疫组化染色 |
| DOI：10.3969/j.issn.1674-3806.2026.03.09 |
| 分类号: |
| 基金项目:广西自然科学基金项目（编号：2022JJA141373）；广西医疗卫生适宜技术开发与推广应用项目（编号：S201642）；广西卫生和计划生育委员会科研课题（编号：Z20180700） |
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| Analysis on the association of IER3 expressions in rectal cancer tissues and preoperative circulating tumor cells with clinicopathological characteristics |
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ZHOU Rizhong1, WEI Chunying2, LI Songlin3, WEI Dangsheng4, ZHONG Xiaogang5
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1.Department of Anorectal Surgery, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530000, China; 2.Department of Dermatology, Red Cross Hospital of Yulin City, Yulin 537000, China; 3.Nanning Emergency Medical Center, Nanning 530000, China; 4.Youjiang Medical University for Nationalities, Baise 533000, China; 5.Department of Gastrointestinal, Hernia & Intestinal Fistula Surgery, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To analyze the expressions of immediate early response 3(IER3) in rectal cancer tissues and preoperative circulating tumor cells(CTCs), and to investigate the association of the IER3 expressions with the patients′ clinicopathological characteristics. Methods A total of 42 patients with rectal cancer who were admitted to the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2017 to January 2019 were recruited. Forty-two healthy individuals undergoing physical examination during the same period were also recruited. At 1 day before operation, 5 mL of peripheral blood was collected from each patient and from each healthy individual at the time of physical examination. The preoperative CTCs levels in the blood samples and the expressions of IER3 mRNA in CTCs were detected by using in situ hybridization technology, and the classification of CTCs was performed. The expression levels of IER3 mRNA in rectal cancer tissues and their adjacent tissues were detected by using quantitative real-time polymerase chain reaction(qRT-PCR), and the expressions of IER3 protein in these tissues were detected by using immunohistochemical staining. The association of the expression levels of IER3 mRNA in rectal cancer tissues with the patients′ clinicopathological characteristics was analyzed. The correlation of the expressions of IER3 mRNA and protein in rectal cancer tissues with the levels of CTCs was analyzed. The associations between the levels of CTCs as well as the levels of CTCs with positive expression of IER3 mRNA and the patients′ clinicopathological characteristics were analyzed. The follow-up was conducted until December 31, 2023 to analyze the associations of the expression levels of IER3 mRNA and protein in rectal cancer tissues with the patients′ survival prognosis. Results The expression level of IER3 mRNA and the positive expression rate of IER3 protein in rectal cancer tissues were significantly higher than those in adjacent tissues(P<0.05). No CTCs were detected in any of the healthy individuals undergoing physical examination. The detection rate of preoperative CTCs in the rectal cancer patients was 92.86%(39/42), among whom 29 patients exhibited IER3 mRNA expression in their CTCs, with an expression rate of 74.36%(29/39). There were no significant differences in the expressions of IER3 mRNA among different types of CTCs(P>0.05). The results of Spearman′s rank correlation analysis showed that the expression level of IER3 mRNA in rectal cancer tissues was negatively correlated with the level of CTCs(rs=-0.317, P=0.041). The expression of IER3 protein in rectal cancer tissues was significantly correlated with the level of total CTCs and the level of mixed CTCs(P<0.05). The level of CTCs was not significantly correlated with the patients′ clinicopathological characteristics(P>0.05). The level of interstitial CTCs with positive expression of IER3 mRNA was significantly correlated with the patients′ N stage, T stage and TNM stage(P<0.05). The levels of epithelial CTCs, mixed CTCs and total CTCs with positive expression of IER3 mRNA were not significantly correlated with the patients′ clinicopathological characteristics(P>0.05). The expressions of IER3 protein and IER3 mRNA in rectal cancer tissues were not significantly correlated with the patients′ survival prognosis(P>0.05). Conclusion IER3 is highly expressed in rectal cancer tissues, which is associated with the pathological characteristics related to tumor invasion and metastasis, as well as with the number and subtypes of CTCs. |
| Key words: Rectal cancer Circulating tumor cells(CTCs) Immediate early response 3(IER3) Immumohistochemical staining |
