CD10、CA9、CD133表达与索拉非尼或舒尼替尼一线治疗转移性肾透明细胞癌患者预后的相关性  

Correlation between CD10,CA9,CD133 and prognosis of mccRCC treated with sorafenib or sunitinib as first-line therapy

作　　者：张昊 郑万祥 刘克普 侯广东 袁建林 ZHANG Hao;ZHENG Wanxiang;LIU Kepu;HOU Guangdong;YUAN Jianlin(Department of Urology,Xijing Hospital of the Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学西京医院泌尿外科,陕西西安710032

出　　处：《现代泌尿外科杂志》2023年第10期867-873,共7页Journal of Modern Urology

摘　　要：目的分析CD10、CA9、CD133表达与索拉非尼或舒尼替尼一线治疗转移性肾透明细胞癌(mccRCC)患者预后的相关性。方法回顾性纳入80例接受索拉非尼或舒尼替尼一线治疗的mccRCC患者,对肿瘤组织标本中CD10、CA9、CD133进行免疫组织化学(IHC)染色,分析各标志物表达与临床病理变量的相关性,采用单因素和多因素Cox比例风险模型分析PFS和OS的预后因素,并对CA9表达与治疗亚组患者的PFS和OS进行Kaplan-Meier生存分析。结果37例(46.25%)患者出现无进展生存期(PFS)的随访结局,中位PFS(mPFS)为24.9个月(95%CI:16.5~33.2)。55例(68.75%)患者死亡,中位总生存期(mOS)为44.2个月(95%CI:14.6~73.7)。CD10低表达与Fuhrman高分级相关(χ^(2)=6.241,P=0.012),CA9低表达与淋巴结转移(χ^(2)=5.952,P=0.015)和转移器官个数≥2个(χ2=8.205,P=0.004)相关。单因素分析显示Fuhrman分级、转移器官数以及淋巴结转移是PFS的预后因素(P<0.05),转移器官数、淋巴结转移及CA9表达是OS的预后因素(P<0.05);多因素分析显示Fuhrman分级是PFS的独立预后因素(HR=2.457,95%CI:1.126~5.365,P=0.024),转移器官数是OS的独立预后因素(HR=1.857,95%CI:1.048~3.290,P=0.034)。治疗亚组患者生存分析,索拉非尼组中CA9高表达与患者更长的OS相关(HR=0.401,95%CI:0.204~0.787,P=0.008)。结论CA9低表达是OS的非独立危险因素,而CD10、CD133不能作为mccRCC的预后因素。CA9低表达的mccRCC患者从索拉非尼和舒尼替尼治疗中生存获益较少,可根据指南选择靶向免疫联合或双免联合治疗以改善预后。Objective To analyze the correlation between the expressions of CD10,CA9 and CD133 and the prognosis of patients with metastatic renal clear cell carcinoma(mccRCC)treated with sorafenib or sunitinib.Methods A total of 80 mccRCC patients who received sorafenib or sunitinib as first-line therapy were retrospectively enrolled.Immunohistochemical staining(IHC)was performed for CD10,CA9 and CD133 in tumor tissue samples to analyze the correlation between the expression of each marker and clinicopathologic variables.Univariate and multivariate Cox proportional risk models were used to analyze prognostic factors of progression free survival(PFS)and overall survival(OS),and Kaplan-Meier survival analysis was performed for CA9 expression and PFS,OS in the treatment subgroups.Results Altogether 37 patients(46.25%)had PFS,and the median PFS(mPFS)was 24.9 months(95%CI:16.5-33.2 months),while 55 patients(68.75%)died and the median OS(mOS)was 44.2 months(95%CI:14.6-73.7).Low expression of CD10 was correlated with high Fuhrman grade(χ^(2)=6.241,P=0.012),lymph node metastasis(χ^(2)=5.952,P=0.015),and the number of metastatic organs≥2(χ^(2)=8.205,P=0.004).Univariate analysis showed that Fuhrman grade,number of metastatic organs and lymph node metastasis were the prognostic factors of PFS(P<0.05),while the number of metastatic organs,lymph node metastasis and CA9 expression were the prognostic factors of OS(P<0.05).Multivariate analysis showed that Fuhrman grade was an independent factor of PFS(HR=2.457,95%CI:1.126-5.365,P=0.024),and the number of metastatic organs was an independent prognostic factor of OS(HR=1.857,95%CI:1.048-3.290,P=0.034).Survival analysis in subgroups showed that high CA9 expression in the sorafenib group was associated with longer OS(HR=0.401,95%CI:0.204-0.787,P=0.008).Conclusion Low expression of CA9 is an non-independent risk factor for OS,while CD10 and CD133 cannot be used as prognostic factors for mccRCC patients.Since mccRCC patients with low CA9 expression have less survival benefit from sorafeni

关 键 词：肾透明细胞癌 肿瘤转移 索拉非尼 舒尼替尼 CD10 CA9 CD133 

分 类 号：R737.11[医药卫生—肿瘤]