直肠癌组织GST-π和Pgp表达与预后关系探讨  

Relationship between the expression of GST-π,Pgp and prognosis in rectal cancer

作　　者：张文洁 潘莲 ZHANG Wen-jie;PAN Lian(Department of Pathology,Fourth People's Hospital of Yixing City,Yixing 214200,China;Department of Pathology,Yixing Hospital of Traditional Chinese Medicine,Yixing 214200,China)

机构地区：[1]宜兴市第四人民医院病理科,江苏宜兴214200 [2]宜兴市中医医院病理科,江苏宜兴214200

出　　处：《社区医学杂志》2022年第5期253-257,共5页Journal Of Community Medicine

摘　　要：目的探究谷胱甘肽S转移酶(GST-π)及耐药基因蛋白(Pgp)在直肠癌组织中表达及其与患者预后的关系。方法收集2016-01-17-2020-02-09宜兴市第四人民医院行直肠癌手术治疗的58例患者的组织标本及一般资料,通过链霉素-生物素过氧化物酶(SP)染色法检测直肠癌组织中GST-π、Pgp水平。随访15个月,统计随访期间患者生存情况,将因癌症死亡者记为死亡组,剩余的为生存组。采用Cox回归模型分析直肠癌患者死亡的相关因素,Kaplan-Meier法分析生存情况。以受试者工作特征(ROC)曲线下面积(AUC)评估GST-π、Pgp因水平对预后的预测价值。结果58例直肠癌患者未出现失访者,其中生存37例,死亡21例。生存组TNM分期ⅡA~ⅡB期所占比例均高于死亡组(χ^(2)=7.067,P=0.008)、高中分化程度所占比例均高于死亡组(χ^(2)=6.843,P=0.009)、不存在淋巴结转移所占比例均高于死亡组(χ^(2)=8.188,P=0.004)、GST-π评分低于死亡组(t=3.680,P<0.001)、Pgp评分低于死亡组(t=3.730,P<0.001)。Cox回归分析结果显示,ⅢA期临床分期、分化程度低、存在淋巴结转移、GST-π及Pgp阳性为影响直肠癌患者预后的相关因素,均P<0.05。ROC分析结果显示,GST-π和Pgp水平预测直肠癌预后的灵敏度分别为76.92和80.76,特异度分别为50.00和53.13,AUC分别为0.635(95%CI为0.491~0.779)和0.638(95%CI为0.495~0.782)。结论存在淋巴结转移、分化程度低、临床分期ⅢA期的直肠癌患者死亡发生率更高,且死亡组GST-π及Pgp表达水平更高。GST-π及Pgp水平对直肠癌预后具有一定的临床预测价值。Objective To explore the expression of glutathione S transferase(GST-π)and drug resistance gene protein P-glycoprotein(Pgp)in rectal cancer tissues and their relationship with the prognosis of patients.Methods Totally 58 patients undergoing surgery for rectal cancer who were admitted to the Fourth People’s Hospital of Yixing City from January 17,2016 to February 9,2020 were selected as the research objects.The general information of patients and tissue samples were collected to detect the levels of GST-πand Pgp in rectal cancer tissue by streptomycin-biotin peroxidase(SP)staining method.The follow-up period was 15 months,and the survival status of the patients during the follow-up period was counted.The cancer-caused death during the follow-up period was recorded as the death group,and the remaining patients as the survival group.Cox regression analysis was used to analyze the related factors of the death of rectal cancer patients,and the Kaplan-Meier method was used to analyze the survival status.The area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the predictive value of GST-π,Pgp and other factors on the prognosis(death).Results In this study,there were no loss of follow-up in 58 patients with rectal cancer.Among them,37 survived(survival group)and 21 died(death group);the proportion of TNM stagesⅡA toⅡB in the survival group was higher than that in the death group(χ^(2)=7.067,P=0.008),the proportion of high-medium differentiation was higher than that in the death group(χ^(2)=6.843,P=0.009),the proportion of no lymph node metastasis is higher than that in the death group(χ^(2)=8.188,P=0.004),GST-πscore was lower than that of the death group(t=3.680,P<0.001),and the Pgp score was lower than that of that in the death group(t=3.730,P<0.001).The results of cox regression analysis showed that the stageⅢA clinical stage,low differentiation,lymph node metastasis,GST-πand Pgp positive were related factors that affected the prognosis of patients with rectal cancer(P<0.

关 键 词：直肠癌 谷胱甘肽S转移酶 耐药基因蛋白 预后 

分 类 号：R735.37[医药卫生—肿瘤]