结直肠癌组织中SATB2、CK20、MUC2表达及其临床意义

doi:10.3870/j.issn.1672-8009.2026.05.008

摘要/Abstract

摘要： 目的探讨结直肠癌（colorectal cancer, CRC）组织中特异性AT富集结合蛋白2（special AT-rich sequence-binding protein 2, SATB2）、细胞角蛋白20（cytokeratin 20, CK20）,黏蛋白2（mucin 2, MUC2）表达的临床意义及其对CRC患者预后评估的价值。方法回顾性选取2020年3月至2022年3月于湖北省中西医结合医院行根治性切除手术治疗的CRC患者的临床资料330例,排除失访等15例后,纳入315例进行生存分析,取CRC组织及配对癌旁组织,免疫组织化学检测三种蛋白质的表达并分组,分析其与临床病理特征的关系,采用Kaplan-Meier法及Cox回归分析预后影响因素。结果 CRC组织中SATB2、MUC2阳性率低于癌旁组织,CK20阳性率高于癌旁组织（P<0.05）。肿瘤直径<4 cm、TNM分期Ⅰ~Ⅱ期及无淋巴结转移患者中SATB2、MUC2阳性率较高,其CK20阳性率较低（P_均<0.05）。单因素及多因素Cox回归分析结果显示,肿瘤直径≥4 cm、TNM分期Ⅲ~Ⅳ期、有淋巴结转移、CK20阳性为预后危险因素,SATB2、MUC2 阳性为保护因素（P_均<0.05）生存分析显示,SATB2、MUC2阳性患者3年死亡率较低,而CK20阳性患者较高（P<0.05）。结论 SATB2、MUC2在CRC组织中表达下调与肿瘤进展密切相关,其阳性表达提示较佳预后;CK20阳性表达则可能与不良预后相关。SATB2、CK20、MUC2表达状态可作为判断CRC患者预后风险的潜在补充标志物。

关键词: 结直肠癌, 特异性AT富集结合蛋白2, 细胞角蛋白20, 黏蛋白2, 预后, 生存分析

Abstract: Objective To investigate the clinical significance of the expression of special AT-rich sequence-binding protein 2 （SATB2）, cytokeratin 20 （CK20）, and mucin 2 （MUC2） in colorectal cancer （CRC） tissues and their value in prognostic evaluation. Methods A total of 330 CRC patients who underwent radical resection at Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine from March 2020 to March 2022 were retrospectively analyzed. After excluding 15 patients lost to follow-up, 315 patients were included in the survival analysis. CRC tissues and paired adjacent normal tissues were collected. Immunohistochemistry was used to detect the expression of the three proteins, and patients were grouped accordingly. The relationships between protein expression and clinicopathological features were analyzed. Kaplan-Meier survival analysis and Cox regression models were used to evaluate prognostic factors. Results The positive expression rates of SATB2 and MUC2 in CRC tissues were lower than those in adjacent tissues, while CK20 expression was higher （P<0.05）. Patients with tumor diameter <4 cm, TNM stage Ⅰ~Ⅱ, and no lymph node metastasis showed higher positive rates of SATB2 and MUC2 and lower CK20 positivity （all P<0.05）. Univariate and multivariate Cox regression analyses indicated that tumor diameter ≥4 cm, TNM stage III-IV, lymph node metastasis, and CK20 positivity were risk factors for poor prognosis, whereas SATB2 and MUC2 positivity was protective factors （all P<0.05）. Survival analysis showed that patients positive for SATB2 and MUC2 had lower 3-year mortality, while those positive for CK20 had higher mortality （P<0.05）. Conclusion The down-regulation of SATB2 and MUC2 expression in CRC tissue is closely related to tumor progression, and their positive expression suggests a better prognosis. The positive expression of CK20 may be related to poor prognosis. The expression status of SATB2, CK20 and MUC2 can be used as potential supplementary markers to judge the prognosis risk of CRC patients.

Key words: colorectal cancer, SATB2 binding protein, cytokeratin 20, mucin 2, prognosis, survival analysis

中图分类号:

R735.3

杨易, 章诗伟. 结直肠癌组织中SATB2、CK20、MUC2表达及其临床意义[J]. 医学分子生物学杂志, 2026, 23(5): 541-548.

YANG Yi, ZHANG Shiwei. Expression of SATB2, CK20 and MUC2 in Colorectal Cancer and Its Clinical Significance[J]. Journal of Medical Molecular Biology, 2026, 23(5): 541-548.

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