结直肠癌根治术患者Nrf2、HO-1因子变化及在预后判断中的应用  

Changes of Nrf2,HO-1 factor in patients undergoing radical resection of colorectal cancer and its application in prognostic judgment

作　　者：徐伟 望小杰 吴磊[1] XU Wei;WANG Xiaojie;WU Lei(Department of General Surgery,Shanghai Baoshan Luodian Hospital,Shanghai 201908,China)

机构地区：[1]上海市宝山区罗店医院普外科,上海201908

出　　处：《检验医学与临床》2022年第17期2314-2319,共6页Laboratory Medicine and Clinic

摘　　要：目的探讨结直肠癌根治术患者转录因子NF-E2相关因子2(Nrf2)、血红素加氧酶-1(HO-1)因子变化及在预后判断中的应用价值。方法选择2017年3月至2020年1月于该院接受结直肠癌根治术治疗的结直肠癌患者84例为研究对象,术中收集癌组织及其配对癌旁正常组织,采用免疫组织化学染色测定患者不同组织中Nrf2、HO-1的表达情况,分析不同临床病理特征患者Nrf2、HO-1表达的差异。根据Nrf2、HO-1界值分层,采用Kaplan-Meier生存函数计算不同分层患者无病生存期(DFS)和总生存期(OS),同时采用Cox回归模型分析结直肠癌患者DFS和OS的独立危险因素。结果结直肠癌组织中Nrf2、HO-1的评分比癌旁组织低(P<0.05);结直肠癌组织中Nrf2、HO-1的低表达率分别为63.95%(55/86)、66.28%(57/86),进一步分析发现,Nrf2、HO-1低表达患者肿瘤浸润深度T3~T4、脉管浸润及TNM分期Ⅲ期例数均高于高表达患者(P<0.05);Kaplan-Meier生存分析显示,结直肠癌组织中Nrf2、HO-1低表达组患者的DFS率和OS率均低于高表达组(P<0.05)。Cox单因素分析结果显示,结直肠癌患者TNM分期Ⅲ期、淋巴结转移分级N2~N3、有脉管浸润、浸润深度T3~T4及组织中Nrf2低表达、HO-1低表达为患者DFS和OS的危险因素(P<0.05)。多因素分析结果显示,TNM分期Ⅲ期及组织中Nrf2低表达、HO-1低表达均为患者DFS和OS的独立危险因素(P<0.05)。结论Nrf2、HO-1在结直肠癌组织中的表达明显低于癌旁组织,其低表达与不良临床病理特征及预后关系紧密,是结直肠癌根治术患者DFS和OS的影响因素,可作为预测术后死亡及复发转移风险的可靠生物标志物。Objective To investigate the changes of transcription factor NF-E2 related factor 2(Nrf2),heme oxygenase-1(HO-1)in patients undergoing radical resection of colorectal cancer and its application in prognostic judgment.Methods A total of 84 patients with colorectal cancer who recevied radical resection for colorectal cancer in the hospital from March 2017 to January 2020 were selected as the reseach subjects.The cancer tissue and its paired normal tissue adjacent to the cancer were collected during the operation,and the difference between the patients was determined by immunohistochemistry.The expression of Nrf2 and HO-1 in tissues,and the differences in the expression of Nrf2 and HO-1 in patients with different clinicopathological characteristics were analyzed.According to the stratification of Nrf2 and HO-1 thresholds,the Kaplan-Meier survival function was used to calculate the disease-free survival(DFS)and overall survival(OS)of patients with different stratifications.At the same time,the Cox regression model was used to analyze the independent risk factors DFS and OS in patients with colorectal cancer.Results The expression scores of Nrf2 and HO-1 in colorectal cancer tissues were significantly lower than those in paired adjacent tissues(P<0.05).The low expression rates of Nrf2 and HO-1 in colorectal cancer were 63.95%(55/86)and 66.28%(57/86),respectively.Further analysis showed that the depth of tumor invasion(T3-T4),vascular invasion and TNM stageⅢcases in patients with low expression of Nrf2 and HO-1 were significantly higher than those in patients with high expression(P<0.05).Kaplan-Meier survival analysis showed that the DFS rate and OS rate of patients with low expression of Nrf2 and HO-1 in colorectal cancer were significantly lower than those in high expression group(P<0.05).Cox univariate analysis showed that TNM stageⅢ,lymph node metastasis grade N2-N3,vascular invasion,depth of invasion T3-T4,low expression of Nrf2 and low expression of HO-1 in tissues were risk factors for DFS and OS in colorect

关 键 词：结直肠癌 转录因子NF-E2相关因子2 血红素加氧酶-1 临床病理特征 

分 类 号：R735.3[医药卫生—肿瘤]