胰腺癌患者癌组织与血清中klotho的表达水平及其临床意义  

Clinical significance of serum and tissue klotho levels in human pancreatic cancer

作　　者：黄曙[1] 周海浪 王敏[2] 范志宁[2] Huang Shu;Zhou Hailang;Wang Min;Fan Zhining(Department of Gastroenterology, People′s Hospital of Lianshui, Huai′an 223400, China;Digestive Endoscopy Department, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]涟水县人民医院消化科,淮安223400 [2]江苏省人民医院消化内镜中心,南京210029

出　　处：《中华胰腺病杂志》2019年第3期194-197,共4页Chinese Journal of Pancreatology

基　　金：2017年度江苏省双创计划项目(苏人才办〔2017〕37号文件);江苏省青年医学重点人才培养项目(QNRC2016442).

摘　　要：目的探讨klotho在胰腺癌组织和血清中的表达水平及其与临床病理参数、患者预后的相关性。方法采用免疫组织化学EnVision二步法检测klotho蛋白在79例胰腺癌及其匹配的癌旁正常组织组成的组织芯片中的表达;通过ELISA法检测39例胰腺癌患者及其临床资料匹配的39例健康者血清klotho蛋白水平,分析klotho表达与胰腺癌临床病理参数与生存期的关系。绘制血清klotho水平的ROC曲线,获取诊断胰腺癌的临界值,计算诊断胰腺癌的敏感度及特异度。结果胰腺癌组织klotho蛋白表达阳性率显著低于癌旁组织(59.5%比96.3%),血清klotho水平显著高于对照组[(670.30±82.24)pg/ml比(310.35±34.65)pg/ml],差异均有统计学意义(P值均<0.001)。胰腺癌klotho蛋白表达与肿瘤临床分期及淋巴结转移呈负相关(P值均<0.05),与患者性别、年龄、肿瘤大小、肿瘤部位、肿瘤局部浸润深度等均无相关性。klotho阳性表达的胰腺癌患者中位生存期显著长于klotho阴性表达患者[(48.31±6.94)个月比(19.50±6.78)个月],差异有统计学意义(P<0.01)。klotho诊断胰腺癌的临界值为376.51 pg/ml,诊断敏感度为84.6%,特异度为87.2%。结论胰腺癌患者组织与血清的klotho表达水平与其临床病理参数及预后密切相关,可作为胰腺癌的潜在肿瘤标志物之一。Objective To investigate the correlation of clinicopathological parameters and prognosis with serum and pancreatic cancer tissue klotho. Methods Immunohistochemistry EnVision two step method was used to assess klotho protein expression of a tissue microarray (TMA) of 79 pairs of pancreatic tissue and normal surrounding tissue. The serum klotho levels in 39 pancreatic cancer patients and 39 healthy controls who had matched clinical data were measured by ELISA. The relationships between the expression of klotho and the clinicopathological features and survival were analyzed. Results Klotho expression positivity in pancreatic cancer tissue was significantly higher than that in adjacent normal tissues (59.5% vs 96.3%);serum level of klotho was markedly higher in pancreatic cancer patients than that in control group [(670.30±82.24)pg/ml vs (310.35±34.65)pg/ml], and both the difference was statistically significant (P<0.001). Klotho expression was negatively associated with tumor clinical stage and lymph node metastasis (P<0.05), and the expression of klotho did not correlate with patients' gender, age, tumor size, location, local invasion depth and the like. The median survival time in pancreatic cancer patients with positive klotho expression were longer than that in in pancreatic cancer patients with negative klotho expression [(48.31±6.94) months vs (19.50±6.78)months], and the difference was statistically significant (P<0.01). ROC analysis on serum klotho gave a cutoff value of 376.51 pg/ml to diagnosis pancreatic cancer with a sensitivity of 84.6% and specificity of 87.2%. Conclusions Klotho level in serum and tissue of pancreatic cancer patients was closely correlated with clinicopathological parameters and prognosis, which may be a potential biomarker for pancreatic cancer.

关 键 词：胰腺肿瘤 KLOTHO基因 肿瘤标记 生物学 

分 类 号：R735.9[医药卫生—肿瘤]