亮氨酸拉链EF-hand结构域跨膜蛋白1、钠氢交换蛋白1和腺苷酸环化酶相关蛋白2在胃癌组织中的表达及对术后复发的预测价值  

The expression of leucine zipper EF-hand domain transmembrane protein 1,sodium hydrogen exchange protein 1 and adenylate cyclase related protein 2 in gastric cancer tissues and their predictive value for postoperative recurrence

作　　者：张健[1] 沈莹 葛卫伟 Zhang Jian;Shen Ying;Ge Weiwei(Department of Pathology,Jiangsu Haimen People's Hospital,Haimen 226100,China;Department of Pathology,Rudong County Hospital of Traditional Chinese Medicine,Nantong 226400,China)

机构地区：[1]海门市人民医院病理科,海门226100 [2]江苏省如东县中医院病理科,南通226400

出　　处：《中国医师进修杂志》2022年第1期60-66,共7页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨亮氨酸拉链EF-hand结构域跨膜蛋白1(LETM1)、钠氢交换蛋白1(NHE-1)和腺苷酸环化酶相关蛋白2(CAP2)在胃癌组织中表达及对术后复发的预测价值。方法回顾性分析海门市人民医院2017年1月至2020年1月92例行外科手术治疗的早期胃癌患者的临床资料。根据术后6个月复发情况分为复发组(16例)和未复发组(76例)。采用实时荧光定量聚合酶链反应法检测手术切除标本的癌组织和癌旁正常组织LETM1、NHE-1和CAP2 mRNA表达水平。采用多因素Logistic回归分析影响胃癌患者术后复发的独立危险因素;绘制受试者工作特征(ROC)曲线,分析LETM1、NHE-1和CAP2 mRNA预测复发的效能。绘制Kaplan-Meier生存曲线,分析不同LETM1、NHE-1和CAP2 mRNA表达水平患者的生存率。结果癌组织LETM1、NHE-1和CAP2 mRNA均明显高于癌旁组织(0.41±0.12比0.22±0.07、0.85±0.27比0.49±0.15和0.31±0.10比0.19±0.06),差异有统计学意义(P<0.01)。复发组N1期比例明显高于未复发组[9/16比22.37%(17/76)],差异有统计学意义(P<0.05);复发组癌组织LETM1、NHE-1和CAP2 mRNA明显高于未复发组(0.61±0.20比0.37±0.13、1.24±0.38比0.77±0.21和0.60±0.19比0.25±0.10),差异有统计学意义(P<0.01)。多因素Logistic回归分析结果显示,控制N分期后,LETM1、NHE-1和CAP2 mRNA仍是影响胃癌患者术后复发的独立危险因素(OR=1.52、3.11和1.21,95%CI 1.26~1.82、2.36~4.09和1.04~1.41,P<0.01)。ROC曲线分析结果显示,LETM1、NHE-1和CAP2 mRNA预测胃癌患者术后复发的曲线下面积(AUC)分别为0.768、0.802和0.850,各指标联合预测胃癌患者术后复发的AUC为0.965。以ROC曲线分析获得的截断值为分界,将患者分为LETM1 mRNA高表达(>0.54,30例)与低表达(≤0.54,62例)、NHE-1 mRNA高表达(>1.09,35例)与低表达(≤1.09,57例)、CAP2 mRNA高表达(>0.49,28例)与低表达(≤0.49,64例)。Kaplan-Meier生存曲线分析结果显示,LETM1、NHE-1和CAP2 mRNA高表达患者生存率明显低�Objective To investigate the expression of leucine zipper EF-hand domain transmembrane protein 1(LETM1),sodium hydrogen exchange protein 1(NHE-1)and adenylate cyclase related protein 2(CAP2)in gastric cancer tissues and the predictive value for postoperative recurrence.Methods The clinical data of 92 patients with early gastric cancer who underwent surgical treatment from January 2017 to January 2020 in Jiangsu Haimen People′s Hospital were retrospectively analyzed.According to the recurrence condition 6 months after operation,the patients were divided into recurrence group(16 cases)and non recurrence group(76 cases).The expression levels of LETM1,NHE-1 and CAP2 mRNA in cancer tissues and adjacent tissues were detected by real time fluorescent quantitative polymerase chain reaction.Multifactor Logistic regression analysis was used to analyze the related influencing factors of postoperative recurrence.The receiver operating characteristic(ROC)curve was drawn,and the effectiveness of LETM1,NHE-1 and CAP2 mRNA in predicting recurrence was analyzed.The Kaplan-Meier survival curve was drawn,and the survival rate was analyzed in patients with different expression levels of LETM1,NHE-1 and CAP2 mRNA.Results The LETM1,NHE-1 and CAP2 mRNA in cancer tissues were significantly higher than those in adjacent tissues(0.41±0.12 vs.0.22±0.07,0.85±0.27 vs.0.49±0.15 and 0.31±0.10 vs.0.19±0.06),and there were statistical differences(P<0.01).The proportion of N1 stage in recurrent group was significantly higher than that in non recurrent group:9/16 vs.22.37%(17/76),and there was statistical difference(P<0.05);the LETM1,NHE-1 and CAP2 mRNA of cancer tissues in recurrent group were significantly higher than those in non recurrent group(0.61±0.20 vs.0.37±0.13,1.24±0.38 vs.0.77±0.21 and 0.60±0.19 vs.0.25±0.10),and there were statistical differences(P<0.01).Multifactor Logistic regression analysis result showed that,after controlled N stages,the LETM1,NHE-1 and CAP2 mRNA were still independent risk factors for postoperative

关 键 词：胃肿瘤 肿瘤复发 局部 亮氨酸拉链EF-hand结构域跨膜蛋白1 钠氢交换蛋白1 腺苷酸环化酶相关蛋白2 

分 类 号：R735.2[医药卫生—肿瘤]