谷氨酰胺转运体ASCT2在结直肠癌中的表达及临床意义  

Glutamine/amino acid transporter （ASCT2） is a novel prognostic marker and predicts metastases in colorectal cancer patients

作　　者：蔡灿锋 唐超明[1] 刘高杰[3] 杨斌[3] 李英儒[3] 吕泽坚[4] 陈国星[1] 陈翔[1] 曾军[1] 韩方海[3] 陈涛[2] 曾兵[2] 

机构地区：[1]清远市人民医院胃肠外科,广东511518 [2]中山大学孙逸仙纪念医院肝胆胰外科 [3]中山大学孙逸仙纪念医院胃肠外科 [4]广东省人民医院胃肠外科

出　　处：《中华实验外科杂志》2015年第10期2557-2559,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目（81401996）;广东省医学科研基金资助项目（A2014228）

摘　　要：目的探讨谷氨酰胺转运体（ASCT2）在结直肠癌中的表达及临床意义。方法采用免疫组织化学法检测104例结直肠癌组织及36例正常组织中ASCT2蛋白的表达。ASCT2的表达与临床病理参数之间的关系采用卡方检验分析。采用Kaplan-Meier法评估其对生存率的影响，采用Log-rank法进行显著性检验，采用Cox回归进行多因素分析。结果104例肿瘤组织中ASCT2高表达组58例，低表达组46例。在高表达组中，肿瘤大于3cm者34例（57．1％），显著多于低表达组（16例，37．5％，P〈0．05）；Ⅲ、IV期患者42例（75．0％），显著多于低表达组（18例，41．7％，P〈0．01）；淋巴结转移阳性38例（64．3％），显著多于低表达组（15例，31．2％，P〈0．01）；肝转移阳性18例（28．6％），显著多于低表达组（5例，10．4％，P〈0．05）。ASCT2高表达组总生存率显著低于低表达组[风险比（HR）=2．05；95％可信区间（CI）：1．12～3．77；P〈0．05]。多因素分析显示ASCT2（P〈0．05）、淋巴结转移（P〈0．01）及肝转移（P〈0．05）为结直肠癌独立预后不良因素。结论ASCT2的高表达与结直肠癌进展密切相关，是其独立预后不良因素之一，可能与增强谷氨酰胺代谢促进肿瘤进展有关。Objective -Glutamine/amino-acid transporter （ASCT2） is a key transporter of gluta- mine that has been implicated in tumor growth and metastasis. However, its clinical significance and role in colorectal cancer （CRC） is largely unknown. Methods The expression of ASCT2 was determined by im- munohistochemistry in CRC samples. The correlation of ASCT2 expression with clinicopathologic features was analyzed. Kaplan - Meier method and log - rank test were used to estimate survival rate. Cox propor- tional hazards model was used to calculate multivariate hazard ratios for the study variables. Results ASCT2 was up - regulated in most of CRC samples, with high expression in 58 cases and low expression in 46 cases. There were 34 （57. 1% ） cases of tumor size larger than 3 cm, 42 （75.0%） cases of later TNM stages, 38 （64. 3% ） cases of lymph node metastasis, and 8 （28. 6% ） cases of liver metastasis in ASCT2 high expression group. It was statistically significant when compared to ASCT2 low expression group （P 〈 0. 05 ）. Patients with high ASCT2 expression had poorer overall survival than those with low ASCT2 expres- sion [hazard ratio （HR） =2. 32; 95% confidence interval （CI） ： 1.26 -4. 26;P 〈0. 01 ]. Furthermore, it was found that ASCT2 expression was an independent prognostic factor for CRC. Conclusion These re- sults indicate that ASCT2 plays a critical role in CRC progression, and may provide a novel metabolism therapeutic target for CRC treatment.

关 键 词：结直肠癌 谷氨酰胺转运体 谷氨酰胺代谢 

分 类 号：R734.2[医药卫生—肿瘤]