01 结直肠癌
02 结直肠癌常用肿瘤标志物
MUC2
Ki-67
Ki-67蛋白是增殖的细胞标志物,与细胞增殖密切相关[8]。其增殖指数是反映细胞增殖的特异性指标,能比较有效地反映细胞的过度增殖情况,与肿瘤分化程度、肿瘤浸润深度、区域淋巴结转移、临床分期及预后有关[9]。
在结直肠癌中,p53也是衡量预后的指标之一。结直肠癌存活率与Ki-67(R=-0.67, p<0.001)和p53(R=-0.64, p<0.001)的表达都呈负相关,Ki-67和p53的过表达都会导致预后不良[10]。 IHC染色定位:主要定位于细胞核。
GPA33
GPA33(A33)基因编码A33抗原,A33抗原是免疫球蛋白超家族的I型跨膜糖蛋白,在正常结肠和小肠上皮细胞以及95%以上的结肠癌患者中表达,在分化良好的肿瘤中尤其明显,是一种有效的标志物[11-12]。有研究提议将GPA33抗体用于放疗来治疗人GPA-33阳性的结直肠癌[13]。
IHC染色定位:在高分化肿瘤和正常组织中,染色通常是膜性的,但在低分化和黏液性肿瘤中,可能主要是细胞质或细胞核。
Villin
绒毛蛋白(Villin)是一种actin结合蛋白,在肠上皮细胞表达,调控结直肠癌的上皮-间质转化(EMT),也参与上皮细胞微绒毛的维持,在结直肠腺癌中阳性率达93%,癌细胞胞质弥漫强(+)伴刷状缘着色加重[14]。研究表明,Villin表达缺失是低分化结肠癌的一个特征,尤其是微卫星不稳定(MSI)肿瘤,并与生存率低有关[14]。
IHC染色定位:细胞质。
CK7(KRT7) / CK20(KRT20)
CK7是一种在肠上皮细胞中表达的细胞角蛋白,在包括结肠在内的许多组织中表达,在结肠中其表达仅限于腺细胞。CK20是在结肠直肠隐窝中的上皮细胞中表达的角蛋白,该蛋白的表达水平从隐窝底部(不存在)到顶部逐渐增加,经常被用作结肠中的一种分化标记[15]。
大多数结直肠癌呈CK7完全阴性/CK20胞质弥漫强阳性,约20%呈CK7(+)/CK20(+),因此CK7/CK20组合应用有助于结直肠腺癌的鉴别诊断。CK7和CK20在结直肠癌的表达随组织学分级和肿瘤部位的不同而不同[16-18]。
虽然大多数肿瘤具有高水平的CK20,但在侵袭性、低分化的结直肠肿瘤和MSI发生率高的结直肠肿瘤中可能呈阴性染色[16, 19]。而在侵袭性强、预后差的BRAF突变的微卫星稳定型结直肠癌中,CK7的表达水平高于其他典型阴性亚型[20]。
IHC染色定位:细胞质。
03 博奥森IHC Kit验证数据
常见肿瘤标志物即用型IHC Kit产品
参考文献
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