食管鳞癌组织Krüppel样因子4和CD44表达与临床病理特征的相关性  

Correlations of the expressions of Krüppel-like factor 4 and CD44 with the clinicopathological characteristics of esophageal squamous cell carcinoma

作　　者：古岳 刘丽娜[2] 高聪聪[1] GU Yue;LIU Li-na;GAO Cong-cong(Department of Gastroenterology,the Second Peopled Hospital of Nanyang f Nanyang,Henan 473000,China;Department of Oncology,the Second Peopled Hospital of Nanyang,Nanyang,Henan 473000,China)

机构地区：[1]南阳市第二人民医院消化内科,河南南阳473000 [2]南阳市第二人民医院肿瘤科,河南南阳473000

出　　处：《中华实用诊断与治疗杂志》2021年第6期580-583,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划项目(2018020987)。

摘　　要：目的观察食管鳞癌(esophageal squamous cell carcinoma,ESCC)患者临床病理特征及食管鳞癌组织Krüppel样因子4(Krüppel-like factor 4,KLF4)、CD44表达情况,探讨KLF4、CD44表达与临床病理特征的关系。方法87例ESCC患者,取其手术切除的肿瘤组织标本(ESCC组)和癌旁正常组织标本(对照组),采用免疫组织化学法检测2组KLF4、CD44阳性表达率;记录ESCC患者临床病理特征,观察ESCC组织KLF4、CD44阳性表达率与临床病理特征的关系。采用多因素logistic回归分析ESCC患者临床分期晚、淋巴结转移的影响因素;绘制ROC曲线,评估ESCC组织KLF4、CD44表达对预测ESCC患者临床分期晚、淋巴结转移的效能。结果ESCC组KLF4阳性表达率(58.62%)低于对照组(85.06%)(P<0.05),CD44阳性表达率(85.06%)高于对照组(9.20%)(P<0.05)。临床分期Ⅲ+Ⅳ期、淋巴结转移患者KLF4阳性表达率(49.09%、43.86%)低于Ⅰ+Ⅱ期(75.00%)、无淋巴结转移者(86.67%)(P<0.05),CD44阳性表达率(91.73%、96.49%)高于Ⅰ+Ⅱ期(71.88%)、无淋巴结转移者(63.33%)(P<0.05);ESCC组织KLF4阴性表达、CD44阳性表达是ESCC患者淋巴结转移(OR=8.320,95%CI:2.568~26.955,P<0.001;OR=15.921,95%CI:3.233~78.414,P<0.001)和临床分期晚(OR=3.111,95%CI:1.192~8.117,P=0.020;OR=4.632,95%CI:1.350~15.895,P=0.015)的危险因素;KLF4阴性表达、CD44阳性表达预测ESCC患者临床分期晚、淋巴结转移的AUC均>0.80,有较好的预测价值。结论ESCC患者癌组织KLF4阴性表达、CD44阳性表达提示临床分期晚、淋巴结转移可能,检测组织中KLF4、CD44表达情况对指导早期临床分期、评估淋巴结转移风险和制定治疗方案有重要价值。Objective To observe the clinicopathological characteristics and the expressions of Krüppel-like factor 4(KLF4)and CD44 in patients with esophageal squamous cell carcinoma(ESCC),and to analyze the correlations of the expressions of KLF4 and CD44 with the clinicopathological characteristics.Methods Eighty-seven patients with ESSC were obtained the surgical resected ESCC tissues(ESCC group)and adjacent normal tissues(control group).Immunohistochemistry was used to detect the positive rates of KLF4 and CD44 in two groups.The clinicopathological characteristics of patients with ESCC were recorded,and the relationships of the expressions of KLF4 and CD44 in ESCC tissues with the clinicopathological characteristics were observed.Multivariate logistic regression was used to analyze the influencing factors of advanced clinical stage and lymph node metastasis in ESCC patients.ROC curve was drawn to evaluate the efficiencies of KLF4 and CD44 expressions on predicting advanced clinical stage and high risk of lymph node metastasis in ESCC patients.Results The positive rate of KLF4 was lower in ESCC group(58.62%)than that in control group(85.06%)(P<0.05),the positive rate of CD44 was higher in ESCC group(85.06%)than that in control group(9.20%)(P<0.05).The positive rates of KLF4 were lower in patients with stageⅢ+Ⅳand lymph node metastasis(49.09%,43.86%)than those in patients with stageⅠ+Ⅱand no lymph node metastasis(75.00%,86.67%)(P<0.05),while the positive rates of CD44 were higher in patients with stageⅢ+Ⅳand lymph node metastasis(91.73%,96.49%)than those in patients with stageⅠ+Ⅱand no lymph node metastasis(71.88%,63.33%)(P<0.05).The negative expression of KLF4 and positive expression of CD44 in ESCC tissues were the risk factors of lymph node metastasis(OR=8.320,95%CI:2.568-26.955,P<0.001;OR=15.921,95%CI:3.233-78.414,P<0.001)and advanced clinical stage(OR=3.111,95%CI:1.192-8.117,P=0.020;OR=4.632,95%CI:1.350-15.895,P=0.015).The AUCs of both KLF4 and CD44 expressions for predicting advanced clinical stage

关 键 词：食管鳞癌 Krüppel样因子4 CD44 临床病理特征 相关性 

分 类 号：R735.1[医药卫生—肿瘤]