SPP1在T1期结直肠癌中的表达与淋巴结转移 之间的关系
The Relationship between SPP1 Expression and Lymph Node Metastasis in T1 Stage Colorectal Cancer
摘要: 目的：探讨分泌性磷蛋白1 (Secreted Phosphoprotein 1, SPP1)在T1期结直肠癌中的表达与淋巴结转移之间的关系。方法：在209例T1期结直肠癌和10例T2~T3期微乳头型结直肠癌石蜡包埋组织中通过免疫组织化学方法检测SPP1表达并分析其表达与淋巴结转移以及其他病理特征之间的关系。结果：1、与高级别上皮内瘤变相比，SPP1在腺癌间质中的表达显著升高(P < 0.001)，且在肿瘤浸润前沿的表达高于肿瘤中央(P < 0.001)。2、肿瘤浸润前沿与肿瘤中央SPP1高表达与肿瘤出芽、低分化肿瘤细胞簇的分级呈正相关。3、与非特殊类型腺癌相比，微乳头型腺癌中观察到SPP1的表达升高(P < 0.05)。4、肿瘤浸润前沿与肿瘤中央SPP1高表达均与脉管侵犯呈正相关(P < 0.05)。5、Logistic多因素回归分析结果显示，肿瘤浸润前沿SPP1高表达和脉管侵犯均是发生淋巴结转移的独立预测因素(P < 0.05)。结论：肿瘤浸润前沿SPP1高表达是T1期结直肠癌发生淋巴结转移的独立预测因素，提示可能用于识别具有淋巴结转移风险的T1期结直肠癌患者，有助于指导临床治疗方案的选择。
Abstract: Objective: To investigate the relationship between the expression of Secreted Phosphoprotein 1 (SPP1) and lymph node metastasis in T1 stage colorectal cancer. Methods: SPP1 expression was detected by immunohistochemistry in paraffin-embedded tissues from 209 cases of T1 stage colorectal cancer and 10 cases of T2~T3 stage micropapillary colorectal cancer. Its expression was analyzed for correlations with lymph node metastasis and other pathological features. Results: 1. Compared with high-grade intraepithelial neoplasia, SPP1 expression was significantly increased in the stroma of adenocarcinoma (P < 0.001) and was higher at the invasive tumor front than in the tumor center (P < 0.001). 2. High SPP1 expression at both the invasive front and the tumor center was positively correlated with the grading of tumor budding and poorly differentiated tumor cell clusters. 3. Elevated SPP1 expression was observed in micropapillary adenocarcinoma compared with non-special-type adenocarcinoma (P < 0.05). 4. High SPP1 expression at both the invasive front and the tumor center was positively correlated with lymphovascular invasion (P < 0.05). 5. Multivariate logistic regression analysis showed that high SPP1 expression at the invasive front and lymphovascular invasion were both independent predictors of lymph node metastasis (P < 0.05). Conclusion: High SPP1 expression at the invasive front is an independent predictor of lymph node metastasis in stage T1 colorectal cancer, suggesting its potential utility for identifying T1 colorectal cancer patients at risk of lymph node metastasis, thereby aiding in clinical treatment decision-making.
文章引用：裴佳欣, 王世钰, 刘慧敏, 尹玉, 蔡永萍. SPP1在T1期结直肠癌中的表达与淋巴结转移 之间的关系[J]. 临床医学进展, 2026, 16(3): 1058-1068. https://doi.org/10.12677/acm.2026.163880

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