目的：分析谷胱甘肽巯基转移酶（glutathione S-transferase，GST）在黏液性及非黏液性大肠癌组织中的表达情况，并探讨其临床意义。方法：选取2007年1月至2012年5月在上海交通大学附属新华医院肛肠外科行手术治疗的109例黏液性大肠癌标本和441例非黏液性大肠癌标本，运用免疫组化方法检测蛋白GST、nm23、细胞角蛋白7（cytokeratin 7，CK7）在黏液性大肠癌和非黏液性大肠癌组织中的表达情况，并探讨其临床意义。结果：GST和nm23在黏液性大肠癌组织中的阳性表达率分别为52.3%和57.8%，明显低于非黏液性大肠癌组织中的阳性率（64.7%，73.0%；均P<0.05），而CK7在黏液性大肠癌组织中的阳性表达率明显高于非黏液性大肠癌组织中的阳性率（27.5% vs 18.4%，P=0.033）。GST的表达与黏液性大肠癌的较低分化程度和较多淋巴结转移相关，nm23和CK7的表达与黏液性大肠癌的临床特征无明显相关性。结论：GST在黏液性和非黏液性大肠癌中存在异常表达，GST蛋白有可能成为检测黏液性大肠癌淋巴结转移和分化程度的生物学指标。

Objective: To study the expression of glutathione S-transferase (GST) in colorectal mucinous adenocarcinoma (MC) and non-mucinous adenocarcinoma (non-MC) and analyze its clinical significance. Methods: The expressions of GST, nm23 and cytokeratin 7 (CK7) in 109 MC and 441 non-MC specimens (from Colorectal Surgery Department, Xinhua Hospital Affiliated to Shanghai Jiaotong University) were detected by using an immunohistochemical method to explore the clinical significance. Results: The positive rates of GST and nm23 in the MC tissues were 52.3% and 57.8% respectively, which were significantly lower than those in the non-MC tissues (64.7%, 73.0%; P<0.05); while the positive rate of CK7 in the MC tissues was 27.5%, which was significantly higher than that in the non-MC tissues (18.4%, P=0.033). The expression of GST was correlated with differentiation and lymph node metastasis of MC; however, no correlation was found between the expressions of CK7 and nm23 and clinical pathological features of MC. Conclusion: GST is abnormally expressed in MC and non-MC tissues, and GST expression might be used as a biomarker of differentiation and lymph node metastasis in MC.

上海交通大学医学院科技基金项目（No. YZ1038）