内科

目的探讨肿瘤相关中性粒细胞(TAN)和上皮-间质转化（EMT）在结直肠癌（CRC）中的临床病理意义。方法回顾性分析随访5年以上的100例CRC患者的病历资料。应用苏木精-伊红染色法检测TAN浸润情况，应用免疫组化法检测EMT标志物上皮钙黏素（E-cadherin）和波形蛋白（vimentin）的表达情况，应用Kaplan-Meier生存曲线对不同TAN浸润情况的CRC患者进行生存情况比较，应用Spearman相关性分析探究TAN浸润和EMT标志物表达之间的关系。结果100例CRC患者中，29例CRC组织中有TAN浸润。CRC组织中E-cadherin的免疫组化染色评分低于癌旁正常组织，vimentin的免疫组化染色评分高于癌旁正常组织（均P＜0.05）。有TAN浸润的CRC患者的TNM分期、淋巴结转移情况较无TAN浸润者差（均P＜0.05）。Kaplan-Meier生存曲线分析结果表示，有TAN浸润的CRC患者的累积生存率低于无TAN浸润的CRC患者（P＜0.05）。Spearman相关性分析结果显示，TAN浸润与E-cadherin表达呈负相关（rs＝-0.498，P＜0.05），与vimentin表达呈正相关（rs=0.611，P＜0.05）。结论TAN浸润与E-cadherin表达呈负相关，与vimentin表达呈正相关；TAN可能通过参与EMT过程，促进CRC的生长和转移。

ObjectiveTo investigate the clinicopathological significance of tumor-associated neutrophil (TAN) and epithelial-mesenchymal transition (EMT) in colorectal cancer (CRC). MethodsThe medical records of 100 patients with CRC who were followed up for more than 5 years were retrospectively analyzed. Hematoxylin-eosin staining was used to detect TAN infiltration, immunohistochemistry was used to detect the expressions of EMT markers (E-cadherin and vimentin), Kaplan-Meier survival curve was used to compare the survival of CRC patients with different TAN infiltration conditions, and Spearman′s correlation analysis was used to explore the correlations between TAN infiltration and EMT markers′ expressions. ResultsOf the 100 CRC patients, 29 had TAN infiltration in CRC tissues. The immunohistochemical staining score of E-cadherin in CRC tissues was lower than that in normal pericarcinous tissues, and the immunohistochemical staining score of vimentin in CRC tissues was higher than that in normal pericarcinous tissues (all P＜0.05). The TNM stage and lymph node metastasis of CRC patients with TAN infiltration were worse than those without TAN infiltration (all P＜0.05). The results of the Kaplan-Meier survival curve analysis showed that the cumulative survival rate of CRC patients with TAN infiltration was lower than that of CRC patients without TAN infiltration (P＜0.05). The results of Spearman′s correlation analysis showed that TAN infiltration was negatively correlated with the E-cadherin expression (rs=-0.498, P＜0.05) but was positively correlated with the vimentin expression (rs=0.611, P＜0.05). ConclusionsTAN infiltration is negatively correlated with the E-cadherin expression but is positively correlated with the vimentin expression; TAN may promote the growth and metastasis of CRC by participating in the EMT process.