羧肽酶A4与非小细胞肺癌患者术后预后关系探讨  

Relationship between carboxypeptidase A4 and postoperative prognosis of patients with non-small cell lung cancer

作　　者：倪国英[1] 倪裕丰[1] 杨志勇 刘合代[1] NI Guoying;NI Yufeng;YANG Zhiyong;LIU Hedai(Chongming Branch Xinhua Hospital Affiliated to Shanghai Jiaotong University,Shanghai 202150,China)

机构地区：[1]上海交通大学附属新华医院崇明分院,上海202150

出　　处：《中国临床医生杂志》2022年第8期914-918,共5页Chinese Journal For Clinicians

基　　金：上海市卫生健康委员会科研课题(201940274)。

摘　　要：目的探讨分析羧肽酶A4(carboxypeptidase A4,CPA4)与非小细胞肺癌患者术后预后的关系。方法选取2018年1月至2019年6月上海交通大学附属新华医院崇明分院收治的经手术治疗且术后病理确诊为非小细胞肺癌患者76例,并留存其术后病理蜡块标本,取其癌组织和癌旁正常组织标本,采用免疫组织化学方法检测不同组织中CPA4表达水平,分析其不同表达水平与非小细胞肺癌微血管密度及术后预后生存的关系。结果非小细胞肺癌癌组织中CPA4阳性表达率85.53%显著高于癌旁组织的26.32%(P<0.05);CPA4表达在存在淋巴结转移患者阳性表达率高于无淋巴结转移患者(P<0.05);肿瘤直径>3cm、存在淋巴结转移患者微血管密度计数显著高于肿瘤直径≤3cm、无淋巴转移患者(P<0.05);CPA4阳性表达患者微血管密度计数为(41.35±9.26),CPA4阴性表达患者微血管密度计数为(28.64±5.37),CPA4随着表达水平的升高,其微血管密度计数逐渐升高。Pearson相关性分析结果显示,CPA4表达水平与微血管密度计数呈弱正相关性(r=0.254,P=0.027)。CPA4阳性表达患者预后生存率为63.16%(48/76),CPA4阴性表达患者预后生存率78..95%(60/76),CPA4阳性表达患者预后生存率显著低于CPA4阴性表达患者(P<0.05);Logistic回归分析结果显示,淋巴结转移(OR=3.842,95%CI:0.748~19.739)、CPA4表达上调(OR=3.364,95%CI:1.360~8.319)是非小细胞肺癌患者术后预后的独立影响因素(P<0.05)。结论非小细胞肺癌患者CPA4呈较高表达,其表达与非小细胞肺癌微血管密度呈正相关关系,CPA4阳性表达是非小细胞肺癌患者术后预后生存的独立危险因素,检测其水平表达,可为临床预后评估提供指导依据。Objective To explore the relationship between carboxypeptidase A4 and postoperative prognosis of patients with non-small cell lung cancer.Method A total of 76 patients admitted to our hospital from January 2018 to June 2019 who were diagnosed with non-small cell lung cancer after surgical treatment and confirmed by postoperative pathology were selected,and their postoperative pathological wax samples were collected,and the expression level of carboxypeptidase A4 in different tissues was detected by immunohistochemistry.To analyze the relationship between different expression levels and microvessel density,postoperative prognosis and survival of NSCLC.Result The positive expression rate of CPA4 in non-small cell lung cancer tissues was 85.53%,which was significantly higher than that in adjacent tissues(26.32%)(P<0.05).The positive expression rate of CPA4 in patients with lymph node metastasis was higher than that in patients without lymph node metastasis(P<0.05).The microvessel density count of patients with tumor diameter>3 cm and lymph node metastasis was significantly higher than that of patients with tumor diameter≤3 cm and no lymph node metastasis(P<0.05).The count was(28.64±5.37),and the microvessel density count of CPA4 increased gradually with the increase of the expression level.The results of Pearson correlation analysis showed that there was a weak positive correlation between CPA4 expression level and microvessel density count(r=0.254,P=0.027).(19.34±3.26)months.The prognosis and survival rate of CPA4-positive patients was 63.16%(48/76),and the prognosis and survival rate of CPA4-negative patients was 78.95%(60/76).The prognosis and survival rate of CPA4-positive patients was significantly lower than that of CPA4-negative patients(P<0.05);Logistic regression analysis showed that lymph node metastasis(OR=3.842,95%CI:0.748~19.739)and up-regulation of CPA4 expression(OR=3.364,95%CI:1.360~8.319)were associated with postoperative prognosis in patients with non-small cell lung cancer.independent influenc

关 键 词：羧肽酶A4 非小细胞肺癌 微血管密度 预后 相关性 

分 类 号：R734.2[医药卫生—肿瘤]