| Summary: | 碩士 === 中山醫學大學 === 生化暨生物科技研究所 === 97 === Surgery is the main curative modality in patients with localized colorectal cancer (CRC), but there is still about 30 to 70 % probability that local relapses occurred. The aim of the present work was to observe cell apoptosis of those patients with localized colorectal cancer who took preoperative chemoradiotherapy and evaluated the possibility that use p53 and Caspase-3 proteins as prognosis indicators on patients. Patients with clinical stage II or III colorectal cancer were selected for sample collection at the time of diagnosis or surgery. The pathology of cancer cell was recorded. Immunohistochemistry was performed to observe the expression of p53 and Caspase-3 proteins in tissue sections. Compared the p53 protein with Caspase-3 protein and analyzed the connections between these two proteins. Our data showed that the expressions of p53 were various differences between the tissue sections. In diagnosis sections, it was observed no detectable p53 (20%), few expressed p53 (12%) and significant expressed p53 (68%). For those diagnosis sections expressed p53, some were detected expression in nucleus only (5%), some were detected expression in cytoplasm only (15%) and some were detected in both nucleus and cytoplasm (80%). In surgery sections, which are collected after preoperative chemoradiotherapy, there were observed no detectable p53 (52%), few expressed p53 (24%) and significant expressed p53 (24%). For those surgery sections expressed p53, some were detected expression in nucleus (42%), some were detected expression in cytoplasm (16%) and some were detected in both nucleus and cytoplasm (42%). Compared with p53, the expressions of Caspase-3 in all sections were weaker and detected in smaller area. In diagnosis sections, there were observed no detectable Caspase-3 (52%), few expressed Caspase-3 (8%) and significant expressed Caspase-3 (40%). For those diagnosis sections expressed Caspase-3, some were detected expression in nucleus (5%), some were detected expression in cytoplasm (5%) and some were detected in both nucleus and cytoplasm (90%). In surgery sections, there was observed no detectable Caspase-3 at all (100%). Serial sections were showed that p53 and Caspase-3 proteins expressed at the same location in diagnosis sections (80%) and some of them expressed p53 and Caspase-3 proteins at the different location instead (20%). Compared diagnosis section with surgery section both of them were from the same patient, lots of the patients (62%) were observed that surgery sections had less expression of p53 than that in diagnosis sections and more than half of patients (56%) were observed that surgery sections had less expression of Caspase-3 than that in diagnosis sections. Some of those patients (31%) were observed that surgery sections had less expression both of p53 and Caspase-3 than that in diagnosis sections. It was observed that the pathology of colorectal cancer on patients (45%) who took preoperative chemoradiotherapy were downstaged. Some of them (36%) were detected significant expression of p53 in diagnosis sections and the expression of p53 was reduced significantly after preoperative chemoradiotherapy. There was no detectable Caspase-3 in surgery sections from patients after preoperative chemoradiotherapy. At the present work, we observed that the pathology on patients with colorectal cancer was downstaged, the expression of p53 was reduced significantly and the expression of Caspase-3 was disappeared after preoperative chemoradiotherapy. Expressions of p53 and Caspase-3 are specific to the patients who were treated with preoperative chemoradiotherapy. It was suggested that p53 and Caspase-3 can be the prognosis indicators by comparing the expressions of these two proteins with the stage of colorectal cancer before and after preoperative chemoradiotherapy.
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