摘要
目的观察Pim-1在结肠癌组织中的表达水平,并分析其与患者预后的相关性关系。方法选择湖北省监利县人民医院2014年10月至2016年10月行外科手术治疗的137例结肠癌患者,其中男性80例,女性57例;年龄43~67岁,平均年龄54.2岁;体质量58.2~69.3 kg,平均体质量63.5 kg;病理诊断分型,高分化28例,中分化72例,低分化37例;TNM分期Ⅰ+Ⅱ期97例,Ⅲ+Ⅳ期40例;肿瘤部位,乙状结肠46例,升结肠48例,横结肠19例,降结肠24例;淋巴结转移42例。采用免疫组织化学法检测结肠癌患者癌组织及癌旁组织Pim-1蛋白表达水平,比较Pim-1蛋白阳性表达率在结肠癌患者不同临床病理特征中的差异性,分析Pim-1蛋白表达与结肠癌患者术后疾病复发、远处转移的相关性关系及对术后3年总生存(OS)率、生存期、无进展生存(PFS)期的影响,同时分析影响结肠癌患者术后预后的多因素。结果结肠癌组织Pim-1蛋白阳性表达率(77.37%,106/137)明显高于癌旁组织(30.66%,42/137)(χ2=20.348,P <0.05);结肠癌患者Pim-1蛋白阳性表达率在TNM分期、组织分化、病灶浸润深度、血管浸润及淋巴结转移等临床病理特征存在明显的差异性(P <0.05);Pim-1蛋白表达阳性患者的术后复发及转移发生率均明显高于Pim-1蛋白表达阴性患者(P <0.05);Pim-1蛋白表达阳性患者术后3年OS率(63.21%,67/106)明显低于Pim-1蛋白表达阴性患者(87.10%,27/31)(χ2=9.154,P <0.05),而中位PFS期(14个月)、中位生存期(20个月)较Pim-1蛋白表达阴性患者(20个月,24个月)明显缩短(t=5.374、6.172,P <0.05);结肠癌病灶组织Pim-1表达半定量计分与术后复发率、转移发生率呈正相关性(r=0.624、0.673,P <0.05),而与术后3年OS率、生存期及PFS期呈负相关性(t=-0.538、-0.561、-0.605,P <0.05);TNM分期(Ⅲ+Ⅳ期)、组织分化(低分化)、浸润深度(侵及浆膜层)、血管浸润(是)、淋巴结转移(是)、Pim-1蛋白表达(阳性)均为影响结肠癌患者术后预后的独立危险因素(P <0.05)。结论 Pim-1蛋白在结肠癌组织呈高水平表达,且Pim-1蛋白表达阳性的结肠癌患者预后不佳,可作为临床预测结肠癌患者预后的有效分子学指标。
Objective To observe the expression level of Pim-1 in colon cancer tissue, and analyze its correlation with prognosis. Methods A total of 137 patients with colon cancer performed surgical treatment from October 2014 to October 2016 were enrolled, which included 80 males and 57 females, aged 43-67 years old with mean age of 54.2 years old;body mass was 58.2-69.3 kg with mean body mass of 63.5 kg. The pathological diagnosis showed that 28 cases were well differentiated,72 of moderately differentiated, and 37 of poorly differentiated;97 cases of TNM stage Ⅰ+ Ⅱ and 40 of TNM stage Ⅲ + Ⅳ.There were 46 cases at sigmoid colon, 48 at ascending colon, 19 at transverse colon and 24 at descending colon;42 cases were lymph node metastasis. The Pim-1 protein expression level of cancer tissues and adjacent tissues of colon cancer patients were detected by immunehistochemical method. The differences of Pim-1 protein positive expression rate in colon cancer patients with different clinical pathological characteristics were compared. The correlation relation between Pim-1 protein expression and postoperative recurrence, distant metastasis, and influence of postoperative 3-year overall survival(OS) rate, survival, and progression-free survival(PFS) were analyzed. The multiple factors influencing postoperative prognosis of colon cancer pa-tient were analyzed. Results The positive expression rate of Pim-1 protein in colon cancer tissues(77.37 %, 106/137) was significantly higher than that of adjacent tissues(30.66 %, 42/137)(χ2= 20.348, P < 0.05);The positive expression incidence of Pim-1 protein in colon cancer patients was significantly different in clinicopathological characteristics such as TNM stage,tissue differentiation, focal invasion depth, vascular invasion and lymph node metastasis(P < 0.05);The incidence of postoperative recurrence and metastasis in patients with positive Pim-1 protein expression was significantly higher than that of patients with negative Pim-1 protein expression(P < 0.05);The 3-year OS rate(63.21 %, 67/106) of patients with positive Pim-1 protein expression was significantly lower than that of patients with negative Pim-1 protein expression(87.10 %, 27/31)(χ2= 9.154,P < 0.05). The median PFS(14-month) and median survival(20-month) were significantly shorter than those with negative Pim-1 protein expression(20-month, 24-month)(t = 5.374, 6.172, P < 0.05);The semi-quantitative scoring of Pim-1 expression in colon cancer lesions was positively correlated with postoperative recurrence rate and metastasis rate(r = 0.624, 0.673, P < 0.05),but was negative correlated with OS rate, survival and PFS at 3-year after operation(t =-0.538,-0.561,-0.605, P < 0.05);The TNM stage Ⅲ + Ⅳ, poorly differentiated tissue differentiation, invasion depth into serosal layer, vascular invasion, lymph node metastasis and Pim-1 protein positive expression were independent risk factors that affected the postoperative prognosis of colon cancer patients(P < 0.05). Conclusion It is demonstrated that Pim-1 protein is highly expressed in colon cancer tissues and prognosis of colon cancer patients with positive Pim-1 protein expression is poor, which could be used as an effective molecular index for prediction of clinical prognosis in colon cancer patients.
作者
张浩渊
何文法
范振龙
ZHANG Hao-yuan;HE Wen-fa;FAN Zhen-long(Department of Second General Surgery,People's Hospital of Jianli,Jianli 433300,Hubei,China;Department of Pathology,People's Hospital of Jianli,Jianli 433300,Hubei,China)
出处
《生物医学工程与临床》
CAS
2020年第6期758-763,共6页
Biomedical Engineering and Clinical Medicine
关键词
PIM-1
结肠癌
蛋白表达
表达阳性
危险因素
预后因素
Pim-1
colon cancer
protein expression
positive expression
risk factors
prognostic factors
