宫颈鳞状细胞癌中染色体结构维持蛋白4细胞毒性T细胞相关抗原4表达变化及与临床预后的关系  

Expression of SMC4 and CTLA4 in cervical squamous cell carcinoma and their relationship with clinical prognosis

作　　者：高婷婷 王兆林 师增增 李雪峰 潘珍妮 王丽[2] Gao Tingting;Wang Zhaolin;Shi Zengzeng;Li Xuefeng;Liang Li;Wang Li(Department of Obstetrics and Gynecology,Tangdu Hospital,Air Force Military Medical University,Xi′an 710038,China;不详)

机构地区：[1]空军军医大学唐都医院妇产科,西安710038 [2]西安医学院附属第一医院产科

出　　处：《山西医药杂志》2023年第8期592-596,共5页Shanxi Medical Journal

摘　　要：目的分析染色体结构维持蛋白4(SMC4)、细胞毒性T细胞相关抗原4(CTLA4)表达变化与宫颈鳞状细胞癌临床病理参数及预后的相关性。方法选择2016年8月至2017年8月于我院收治宫颈鳞状细胞癌患者56例为观察组,同期选择于我院检查的健康人群35名为对照组,免疫组织化学检测2组病理组织SMC4、CTLA4表达情况,采集并比较2组患者临床资料。采用多因素Logisitic回归分析影响宫颈鳞状细胞癌病发患者的危险因素,Kaplan-Meier生存曲线分析SMC4、CTLA4表达在宫颈鳞状细胞癌预后的关系。采用受试者工作特征曲线(ROC曲线)分析SMC4、CTLA4指标的曲线下面积(AUC)、灵敏度、特异度。结果相较于对照组,观察组宫颈组织SMC4、CTLA4表达评分明显升高,同时观察组流产、绝经、首次性交年龄小、首次生育年龄小、孕次多比例明显升高(P<0.05)。多因素Logisitic回归分析发现,SMC4高表达、CTLA4高表达、流产、绝经、首次性交年龄小、首次生育年龄小、孕次多均为影响宫颈鳞状细胞癌病发危险因素(P<0.05)。Kaplan-Meier生存分析结果显示,56例宫颈鳞状细胞癌患者平均随访时间为34个月,高表达SMC4(≥2.45,26例)患者总生存期明显低于低表达SMC4(30例)患者,高表达CTLA4(≥2.39,28例)患者总生存期明显低于低表达CTLA4(28例)患者(P<0.05)。ROC曲线分析发现,SMC4、CTLA4诊断宫颈鳞状细胞癌的AUC为0.723、0.725,两者联合诊断宫颈鳞状细胞癌的AUC为0.854。结论SMC4、CTLA4对预测宫颈鳞状细胞癌治疗预后具有一定的价值,患者SMC4、CTLA4水平升高提示预后不良风险较高,有望作为宫颈鳞状细胞癌的早期诊断生物学标志物。Objective To analyze the correlation between the expression of chromosome structure maintenance protein 4(SMC4)and cytotoxic T lymphocyte associated antigen 4(CTLA4)and the clinicopathologic parameters and prognosis of cervical squamous cell carcinoma.Methods Fifty-six patients with cervical squamous cell carcinoma admitted to our hospital from August 2016 to August 2017 were selected as the observation group,and 35 healthy people examined in our hospital were selected as the control group at the same time.The expression of SMC4 and CTLA4 in the pathological tissues of the two groups were detected by immunohistochemistry,and the clinical data of the two groups were collected and compared.Multivariate Logistic regression analysis was used to analyze the risk factors affecting the occurrence of cervical squamous cell carcinoma.Kaplan-Meier survival curve was used to analyze the relationship between the expression of SMC4 and CTLA4 in the prognosis of cervical squamous cell carcinoma.The area under curve(AUC),sensitivity and specificity of each SMC4 and CTLA4 index were analyzed using the subject operating characteristic curve(ROC curve).Results Compared with the control group,the expression score of SMC4 and CTLA4 in the cervical tissue of the observation group was significantly higher,while the proportion of abortion,menopause,first sexual intercourse,first birth,multiple pregnancies in the observation group were significantly higher(P<0.05).Multivariate Logistic regression analysis showed that high expression of SMC4,high expression of CTLA4,abortion,menopause,small age of first sexual intercourse,small age of first birth,multiple pregnancies were all risk factors for cervical squamous cell carcinoma(P<0.05).Kaplan-Meier survival analysis showed that the average follow-up time of 56 patients with cervical squamous cell carcinoma was 34 months.The total survival time of patients with high expression of SMC4(≥2.45,n=26)was significantly lower than that of patients with low expression of SMC4(n=30),and that of pat

关 键 词：癌 鳞状细胞 宫颈肿瘤 染色体结构维持蛋白4 细胞毒T细胞分子4 临床预后 

分 类 号：R737.33[医药卫生—肿瘤]