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目的：探讨结直肠癌组织中酸性核磷蛋白32A（ANP32A）、Ataxin-3及4个半LIM结构域蛋白1（FHL1）的表达及其与肝转移的关系。方法：对120例结直肠癌患者癌组织和癌旁组织中ANP32A、Ataxin-3及FHL1蛋白水平进行检测，分析其阳性表达率。其中44例发生肝转移作为肝转移组，76例无肝转移作为无肝转移组，比较两组癌组织中ANP32A、Ataxin-3及FHL1蛋白阳性表达率，分析结直肠癌肝转移的影响因素，分析ANP32A、Ataxin-3、FHL1蛋白之间的相关性。结果：结直肠癌患者癌组织中ANP32A蛋白阳性表达率高于癌旁组织，Ataxin-3、FHL1蛋白阳性表达率低于癌旁组织（P<0.05）。经单因素分析显示肝转移组患者癌组织中ANP32A蛋白阳性表达率显著高于无肝转移组，Ataxin-3、FHL1蛋白阳性表达率显著低于无肝转移组（P<0.05），肝转移组患者原发癌中低分化、原发癌浸润深度T3~T4、原发癌有淋巴结转移者构成比显著高于无肝转移组（P<0.05）。多因素Logistic回归分析显示，ANP32A蛋白阳性表达、原发癌中低分化、原发癌浸润深度T3~T4、原发癌有淋巴结转移是结直肠癌肝转移的危险因素（P<0.05），Ataxin-3、FHL1蛋白阳性表达是结直肠癌肝转移的保护因素（P<0.05）。Spearman相关分析显示，结直肠癌患者癌组织中ANP32A阳性表达率与Ataxin-3、FHL1阳性表达率呈负相关（P<0.05），Ataxin-3蛋白阳性表达率与FHL1蛋白阳性表达率呈正相关（P<0.05）。结论：ANP32A蛋白高表达，Ataxin-3、FHL1蛋白低表达与结直肠癌发生及肝转移有密切关系，且以上指标间具有一定相关性。结直肠癌肝转移受多种因素影响，临床诊治中可根据相关因素为患者制定针对性治疗方案。

英文摘要:

Objective: To investigate the expression of acidic nuclear phosphoprotein 32A (ANP32A), Ataxin-3 and four half LIM domain proteins 1 (FHL1) in colorectal cancer and their relationship with liver metastasis. Methods: The protein levels of ANP32A, Ataxin-3 and FHL1 protein in 120 cases of colorectal cancer were detected by immunohistochemistry, the positive expression rate was analyzed. Among thems, 44 cases with liver metastasis were regarded as liver metastasis group, 76 cases without liver metastasis were regarded as non liver metastasis group, the positive expression rates of ANP32A, Ataxin-3 and FHL1 were compared between the two groups, the influencing factors of colorectal cancer liver metastasis were analyzed, and the correlation between ANP32A, Ataxin-3 and FHL1 protein were analyzed. Results: The positive expression rate of ANP32A protein in colorectal cancer tissues was higher than that in adjacent tissues, and the positive expression rates of Ataxin-3 and FHL1 protein in colorectal cancer tissues were lower than those in adjacent tissues (P < 0.05). Univariate analysis showed that the positive expression rate of ANP32A protein in liver metastasis group was significantly higher than that in non liver metastasis group, and the positive expression rates of Ataxin-3 and FHL1 protein in liver metastasis group were significantly lower than those in non liver metastasis group (P < 0.05). The proportion of patients with low differentiation, T3-T4 invasion depth and lymph node metastasis in liver metastasis group was significantly higher than that in non liver metastasis group (P < 0.05). Multivariate logistic regression analysis showed that positive expression of ANP32A protein, low differentiation of primary cancer, depth of invasion T3-T4 and lymph node metastasis were risk factors for liver metastasis of colorectal cancer (P < 0.05). Positive expression of Ataxin-3 and FHL1 protein were protective factors for liver metastasis of colorectal cancer (P < 0.05). Spearman correlation analysis showed that the positive expression rate of ANP32A was negatively correlated with the positive expression rate of Ataxin-3 and FHL1 (P < 0.05), and the positive expression rate of Ataxin-3 was positively correlated with the positive expression rate of FHL1 (P < 0.05). Conclusion: The high expression of ANP32A and the low expression of Ataxin-3 and FHL1 are closely related to the occurrence and liver metastasis of colorectal cancer. Positive expression of ANP32A, low differentiation of primary cancer, depth of invasion T3-T4 and lymph node metastasis were risk factors for liver metastasis of colorectal cancer. Positive expression of Ataxin-3 and FHL1 protein were protective factors for liver metastasis of colorectal cancer.

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