KRT4在喉癌及癌旁正常黏膜组织中的表达及临床意义  

Expression and clinical significance of KRT4 in laryngeal carcinoma and adjacent normal mucosal tissues

作　　者：王靖淞 余灿 张西 邓启成 谢卓良 赵锐[1] 温蓓[2] 刘海[1] WANG Jingsong;YU Can;ZHANG Xi;DENG Qicheng;XIE Zhuoliang;ZHAO Rui;WEN Bei;LIU Hai(Department of Otorhinolaryngology&Head and Neck Surgery,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China;Department of Otorhinolaryngology&Head and Neck Surgery,Sichuan Provincial People's Hospital,Chengdu 610031,Sichuan,China)

机构地区：[1]川北医学院附属医院耳鼻咽喉头颈外科,四川南充637000 [2]四川省人民医院耳鼻咽喉头颈外科,四川成都610031

出　　处：《山东大学耳鼻喉眼学报》2024年第3期12-17,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：四川省医学青年创新科研课题计划(S19055)

摘　　要：目的探讨角蛋白4(keratin 4,KRT4)在喉癌患者中的表达水平与临床病理特征及预后之间的关系。方法收集喉癌组织标本70例、对应癌旁正常黏膜组织标本70例和声带息肉组织标本40例,采用免疫组化SP法和统计学分析KRT4表达与喉癌的临床病理特征及预后之间的关系。结果免疫组化SP法显示,KRT4在喉癌组织的表达水平明显低于癌旁正常黏膜组织、声带息肉组织,差异具有统计学意义(χ^(2)=51.511,P<0.001)。KRT4的表达水平与患者的临床分期(χ^(2)=5.741,P=0.017)、分化程度(χ^(2)=6.713,P=0.010)以及颈部淋巴结转移(χ^(2)=4.639,P=0.031)之间存在显著的相关性。单因素Log-rank检验分析显示,KRT4表达(χ^(2)=23.962,P<0.001)、临床分期(χ^(2)=4.621,P=0.032)、颈部淋巴结转移(χ^(2)=7.549,P=0.006)与喉癌预后相关,Kaplan-Meier生存曲线提示KRT4阳性表达组的存活率明显高于KRT4阴性表达组。Cox回归模型研究发现KRT4表达是影响喉癌预后的独立危险因素。结论KRT4在喉癌组织中的表达水平明显低于癌旁正常黏膜组织、声带息肉组织,且KRT4表达与患者的临床分期、分化程度及颈部淋巴结的转移有关,KRT4阳性表达的喉癌患者预后更好。因此,KRT4有望成为一种重要的生物学指标,用以指导喉癌的诊断、治疗以及预后评估。Objective To investigate the relationship between the expression level of keratin 4(KRT4)in laryngeal cancer patients and the clinicopathological characteristics and prognosis of the patients.Methods 70 specimens of laryngeal cancer tissue,70 specimens of normal mucosa tissue adjacent to cancer,and 40 specimens of vocal cord polyp tissue were collected.Immunohistochemical SP method was used,and the relationship between KRT4 expression and clinical pathological characteristics and prognosis of laryngeal cancer was analyzed statistically.Results The immunohistochemical SP method showed that the expression level of KRT4 in laryngeal cancer tissue was significantly lower than that in adjacent normal mucosal tissue and vocal cord polyp tissue,and the difference was statistically significant(χ^(2)=51.511,P<0.001).There were significant correlationbetween the expression level of KRT4 and the clinical stage(χ^(2)=5.741,P=0.017),degree of differentiation(χ^(2)=6.713,P=0.010),and cervical lymph node metastasis of patients(χ^(2)=4.639,P=0.031).Single factor Log rank test analysis showed that KRT4 expression(χ^(2)=23.962,P<0.001),clinical stage(χ^(2)=4.621,P=0.032),cervical lymph node metastasis(χ^(2)=7.549,P=0.006),and prognosis of laryngeal cancer were correlated.The Kaplan Meier survival curve showed that the survival rate of the KRT4 positive expression group was significantly higher than that of the KRT4 negative expression group.Further research using Cox regression models revealed that KRT4 expression is an independent risk factor affecting the prognosis of laryngeal cancer.Conclusion The expression level of KRT4 in laryngeal cancer tissue is significantly lower than that in normal mucosa tissue and vocal cord polyp tissue adjacent to the cancer,and the expression of KRT4 is related to the clinical stage,differentiation degree,and cervical lymph node metastasis of patients.Laryngeal cancer patients with positive expression of KRT4 have a better prognosis.Therefore,KRT4 is expected to become an important biologi

关 键 词：喉癌 角蛋白4 免疫组化 颈部淋巴结转移 COX回归模型 Kaplan-Meier生存曲线 

分 类 号：R739.65[医药卫生—肿瘤]