706例食管癌术后并发症诱因及早晚期食管癌关键基因差异性表达研究  

Analysis of predisposing factors of postoperative complications of 706 patients and the differential expression of key genes in early and advanced stages of esophageal cancer

作　　者：朱溢智 徐叶 王雪艳[1] 刘凌翔[2] ZHU Yizhi;XU Ye;WANG Xueyan;LIU Lingxiang(Nanjing Medical University, Nanjing, Jiangsu, 2 10000;Department of Oncology,The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029)

机构地区：[1]南京医科大学,江苏南京210000 [2]南京医科大学第一附属医院肿瘤科,江苏南京210029

出　　处：《实用临床医药杂志》2017年第19期91-94,98,共5页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金面上项目(81472782);江苏省自然科学基金面上项目(BK20141491)

摘　　要：目的探讨食管癌术后并发症诱因,并对关键基因的mRNA、甲基化以及突变对不同食管癌分期的表达差异性进行分析。方法将2010—2013年以及2015—2016年南京医科大学第一附属医院暨江苏省人民医院食管癌术后共706例连续患者进行回顾性分析。从癌症基因组图谱(TCGA)数据库中共得到食管癌患者基因数据后进行统计分析。结果患者年龄与术后败血症发生相关(P=0.011),术后p TNM分期与吻合口瘘(P=0.010)以及乳糜漏(P=0.030)的发生相关,患者的术后营养方式与吻合口瘘(P=0.041)的发生也显著相关。对不同分期的食管癌患者,EPHA3 mRNA表达存在显著差异(P=0.006);NOTCH1 DNA甲基化水平存在显著差异(P=0.027);具有统计学意义差异的突变基因是ZNF750(P=0.037)、MALAT1(P=0.044)。结论食管癌患者术后并发症的发生与患者年龄、肿瘤TNM分期以及术后营养方式相关。EPHA3的mRNA表达、NOTCH1的甲基化在食管癌不同TNM分期下存在明显差异,并且二者在中晚期患者中表达水平更高,ZNF750和MALAT1的缺失或插入性突变与食管癌的分期均呈负相关。ObjectiveTo study the predisposing factors of postoperative complications of esophageal cancer, and analyze the different genetic expression of mRNA, DNA methylation and mutations with different esophageal cancer staging. MethodsA total of 706 patients with esophageal cancer from the First Affiliated Hospital of Nanjing Medical University and Jiangsu People′s Hospital from 2010 to 2013 and 2015 to 2016 were involved in this study. Data of genetic information from 107 patients with esophageal cancer were obtained from the Cancer Genome Atlas （TCGA） database. ResultsThe analysis showed that age was correlated with SEP （P=0.011）, and pTNM staging was correlated with the occurrence of AF （P=0.010） and CL （P=0.030）. The postoperative nutritional pattern was also significantly associated with the occurrence of AF （P=0.041）. There was a significant difference in the expression of EPHA3 mRNA in patients with esophageal cancer in different TNM stage （P=0.006）, DNA methylation level of NOTCH1 （P=0.027）, and mutations genes such as ZNF750 （P=0.037） and MALAT1 （P=0.044）. ConclusionPostoperative complications of esophageal cancer could be associated with patients′age, TNM staging and postoperative nutritional patterns. The expression of EPHA3 mRNA and the DNA methylation of NOTCH1 show significant difference in different TNM stages of esophageal cancer, and both of them have higher expression in advanced patients. Mutation of ZNF750 and MALAT1 are negatively correlated with the staging of esophageal carcinoma.

关 键 词：食管癌 并发症 诱因 肿瘤分期 mRNA 甲基化 突变基因 差异 

分 类 号：R735.1[医药卫生—肿瘤]