肿瘤组织中具核梭杆菌丰度作为Ⅱ期结直肠癌预后标志物的临床研究  

Clinical investigation in abundance of Fusobacterium nucleatum in tumor tissues as a prognostic biomarker for stageⅡcolorectal cancer

作　　者：李东霖 郭怀娟 王颖[1] 严雪冰 陆美玲[1] LI Donglin;GUO Huaijuan;WANG Ying;YAN Xuebing;LU Meiling(Department of Oncology,the Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu,225000)

机构地区：[1]扬州大学附属医院肿瘤科,江苏扬州225000

出　　处：《实用临床医药杂志》2023年第9期25-31,共7页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金(81902422);江苏省卫生健康委面上项目(M2020024);江苏省研究生科研与实践创新计划项目(SJCX21-1646,SJCX22-1815);江苏省科协青年科技人才托举工程(TJ-2022-022);江苏省扬州市重点研发项目(社会发展)(YZ2020078);扬州大学医学创新转化专项基金临床转化研究项目(AHYZUZHXM202104)。

摘　　要：目的评估肿瘤组织中具核梭杆菌(Fn)丰度对Ⅱ期结直肠癌(CRC)患者预后的影响。方法收集2013年1月-2018年12月151例在扬州大学附属医院接受手术治疗的Ⅱ期CRC患者的肿瘤标本,通过定量聚合酶链反应检测肿瘤组织中Fn的基因相对表达水平,并通过中位数法将其分为Fn高丰度组和Fn低丰度组。采用卡方检验分析Fn丰度与临床特征的相关性。采用Kaplan-Meier生存曲线分析Fn丰度对患者肿瘤特异性生存期(CSS)和无病生存期(DFS)的影响。基于Cox风险比例回归模型的单因素和多因素明确Fn丰度是否为预后的独立影响因素。结果Fn丰度与Ⅱ期CRC患者临床特征均无显著相关性(P>0.05)。Ⅱ期CRC患者中,Fn丰度与患者的CSS及DFS呈负相关(P=0.01)。单因素及多因素分析结果表明,Fn丰度为影响Ⅱ期CRC患者CSS及DFS的独立影响因素(P<0.05)。亚组分析结果表明,Fn丰度与Ⅱ期低危患者的CSS及DFS无显著相关性(P=0.22、0.47),但与高危患者的CSS及DFS呈负相关(P<0.01)。单因素及多因素分析结果表明,Fn丰度为Ⅱ期高危CRC患者CSS及DFS的独立影响因素。结论肿瘤组织中Fn丰度为Ⅱ期高危CRC患者预后不良的独立影响因素,靶向Fn有望成为防治CRC术后复发转移的新策略。Objective To evaluate the prognostic impact of abundance of Fusobacterium nucleatum(Fn)in the tumor tissues in stageⅡcolorectal cancer(CRC)patients.Methods Tumor specimen of 151 CRC stageⅡpatients receiving surgical treatment at Affiliated Hospital of Yangzhou University between January 2013 and December 2018 were collected.The relative levels of Fn gene in the CRC tissues were detected using quantitative real-time polymerase chain reaction,and were divided into highFn level group and low Fn abundance group using the median method.The chi-square test was used to analyze the correlation between Fn abundance and clinical features.The Kaplan-Meier survival analysis was used to clarify the impacts of Fn abundance on the cancer-specific survival(CSS)and disease-free survival(DFS)of the patients.The univariate and multivariate analysis based on the Cox proportional hazard model was used to identify whether Fn abundance was an independent prognostic factor. Results No significant correlation was observed between Fn abundance in the CRC tissues and any of clinical features(P>0.05).In the stageⅡCRC patients,Fn abundance was negatively correlated with the CSS and DFS(P=0.01).The univariate and multivariate analysis revealed Fn abundance was an independent unfavorable factor affecting CSS and DFS(P<0.05).Subgroup analysis showed that Fn abundance had no relation with the CSS or DFS of low-risk stageⅡpatients(P=0.22,0.47),but was negatively correlated with that of high-risk stageⅡpatients(P<0.01).The univariate and multivariate analysis revealed Fn abundance was an independent factor affecting CSS and DFS in the high-risk stageⅡCRC patients. Conclusion Fn abundance in the CRC tissues is identified as an independent influencing factor for high-risk stageⅡCRC patients.Targeting Fn may be a novel strategy to the prevent postoperative recurrence and progression of CRC.

关 键 词：具核梭杆菌 丰度 结直肠癌 预后 复发 转移 化疗 生物标志物 

分 类 号：R735.3[医药卫生—肿瘤] R730.5[医药卫生—临床医学]