The Expression And Clinical Significance Of Estrogen Receptor And PTEN In Young Women With Colorectal Cancer

Part 1EPIDEMIOLOGICAL INVESTIGATION OF THE INCIDENCE OF YOUNG-ONSET COLORECTAL CANCER IN CHINAObjective Through collecting and sorting out the data of young Chinese colorectal cancer incidence and mortality from 2004~2009 in Chinese cancer registry annual report,analyze and compare the trend of incidence and mortality in young patients,and to compare the difference of incidence and mortality between different regions and different sex in China.explore the main reason accounting for this difference,to find the major external factors leading to the change of young-onset colorectal cancer in China,in order to find the appropriate measures to reduce the incidence and mortality rate of young patients with colorectal cancer.Methods To collect and collate the data on incidence and mortality of colorectal cancer in China from 2004~2009,using Excel table to calculate the incidence and mortality of young–onset colorectal cancer(age from 20~39 years old)in China,and the young –onset colon and rectal cancer incidence and mortality from 2003~2007.using spss20.0 to compare the difference of colorectal cancer between different areas,sexes and locations.Results(1)The incidence and mortality rate of the youth colorectal cancer was increased in China and the urban area from 2004~2009,while in rural area,the trend is decreasing.(2)The incidence rate of young colorectal cancer in urban area is higher than that in rural area,while the mortality rate is lower than rural area from 2004~2009.(3)The incidence rate of colorectal cancer in young men was higher than that of young women,but there was no significant difference in mortality from 2004~2009.(4)From 2003~2007,there was little difference between the incidence of colon and rectal cancer in China and the urban area,the mortality rate of rectal cancer is higher than that of colon cancer,and the incidence and mortality of rectal cancer in rural area is higher than that of colon cancer.The colon and rectal cancer incidence rate in urban area is higher that in rural area,there was no significant difference in mortality between the two places.Conclusions The incidence and mortality rate of young-onset colorectal cancer in China is increasing year by year,this may be related with the improvement of people's living standard,change of life habits and daily diet structure,too large life pressure,environmental pollution and so on.Pay attention to the young–onset colorectal caner in China and advocate a healthy lifestyle is urgent.Part 2EXPRESSION AND CLINICALSIGNIFICANCE OF ESTROGEN RECEPTOR AND PTEN IN YOUNGFEMALE COLORECTAL CANCERObjective Compare the difference of pathological and clinical characteristics between young women and elderly women colorectal cancer patients,detect the expression level of ER ?,ER ? and PTEN in colorectal cancer tissues,to explore their relationship with clinical pathological parameters and the relationship between ER ? and PTEN,ER ? and ER ?,speculate their role in the development of female colorectal cancer.Methods Collect colorectal cancer and precancerous tissue paraffin block of 30 cases of young women and 20 cases of elderly women,using immunohistochemical to detect the expression and cellular localization of ER alpha,ER beta and PTEN in females' tumor and precancerous tissues.Compare the expression levels of ER ?,ER ? and PTEN in colorectal cancer tissues and corresponding adjacent tissues,their relationship with clinical pathological parameters and apoptotic index.Collect 6 young women,6 elderly women fresh colorectal cancer and adjacent tissue,using Western blotting method to detect the quantitative level of ER alpha and ER beta in colorectal cancer tissue and the adjacent normal tissues,to further verify the expression of ER alpha,ER beta difference between colorectal cancer tissues and the corresponding adjacent normal tissues.Using spss20.0 to analyze the different expression of ER alpha,ER beta and PTEN in young women and elderly women between colorectal cancer tumor tissues and corresponding adjacent tissues,P<0.05 has statistically significant.Results(1)The differentiation degree of colorectal cancer in the elderly female group was significantly higher than that in the young women group(95%:70%,P=0.03);(2)The positive expression rate of ER alpha in colorectal cancer tissues was significantly higher than that in the adjacent tissues(82%:44%,P =0),western blotting showed the same results(OD 1.28±0.13:1.06±0.24,P =0.02),there are statistically significant difference;The expression rate of ER alpha has little association with clinical pathological parameters,though the relationship between ER alpha and apoptotic index has no statistically significant difference,the apoptosis index of ER positive colorectal cancer group(7.37%±5.34%)was significantly lower than that of ER negative group(12.78%±7.53%).(3)ER beta expression in colorectal cancer tissues was significantly lower compared with adjacent normal tissues(32%:54%,P=0.03),western blotting result: the OD in colorectal cancer is 1.21±0.2,in normal tissues is 1.50±0.22,P=0.04;The positive expression rate of ER beta was related to Dukes stage and lymph node metastasis of tumor,P<0.05,the relationship with tumor differentiation was not statistically significant,the apoptotic index in ER beta positive group is higher than ER beta negative group(8.75%±4.24%:8.15%±6.83%,P=0.75),has no significant statistical difference.(4)Compared with adjacent normal tissues,in colorectal cancer tissues PTEN expression was significantly lower(cancer : normal is 36%:90%,P=0).There has no significant statistical difference in the relationship between PTEN expression level and clinical pathological parameters,but with the increased degree of malignancy,the positive rate of PTEN decreased gradually.The apoptosis index in PTEN positive group is higher than PTEN negative group(8.78%±4.74%:8.09%±6.78%,P=0.7).(5)The apoptosis index in colorectal cancer tissues was significantly lower than in adjacent group(8.34% ±6.08%:11.20% ± 6.70%,P=0.03).The relationship between apoptosis index level and clinic pathological parameters was not statistically significant.(6)In colorectal carcinoma,the expression level of ER beta was positively related to PTEN expression level(R=0.468,P=0);The relationship between ER alpha and ER beta in colorectal cancer had no obvious relevance,P>0.05.Conclusions Compared with the elderly female with colorectal cancer,young women patients has a relatively high malignant degree,but there was no significant difference in the expression of ER alpha,ER beta,PTEN and apoptosis index between the two groups.But the expression level of ER alpha in colorectal cancer group was increased,the expression level of PTEN and ER beta was decreased.Young women colorectal cancer may be related with the decreasing level of serum estradiol,the imbalance between the expression of ER alpha and ER beta,the decreased expression of PTEN mediated by the expression of ER beta.