CD13在胃癌中的表达与临床病理参数的关系及其对远期预后的预测价值  

The relationship between CD13 expression and clinicopathological parameters in gastric cancer and its predictive value for long term prognosis

作　　者：张朝阳 杨子 李洪涛[3] 张文静 赵萌 王娟[5] 左芦根 张小凤 ZHANG Chaoyang;YANG Zi;LI Hongtao;ZHANG Wenjing;ZHAO Meng;WANG Juan;ZUO Lugen;ZHANG Xiaofeng(Clinical Trials Center,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China;不详)

机构地区：[1]蚌埠医学院第一附属医院临床试验研究中心,安徽蚌埠233004 [2]蚌埠医学院第一附属医院胃肠外科 [3]蚌埠医学院第一附属医院肿瘤外科 [4]蚌埠医学院第一附属医院检验科 [5]蚌埠医学院第一附属医院肿瘤内科 [6]蚌埠医学院第一附属医院中心实验室

出　　处：《中华全科医学》2023年第12期2018-2021,共4页Chinese Journal of General Practice

基　　金：国家自然科学基金项目(81700476);蚌埠医学院省级重点科研平台开放课题基金项目(KFDX202202)。

摘　　要：目的分析丙氨酰(膜)氨肽酶(CD13)在胃癌组织中的表达情况及与临床病理参数间的关系,并评估其对患者远期预后的预判价值。方法纳入2015年1月—2018年1月于蚌埠医学院第一附属医院接受胃癌根治术的患者117例,利用免疫组化法分析CD13在胃癌组织中的表达情况,并评估其与临床病理参数间的关系及对患者术后5年生存率的预测价值。结果胃癌组织中CD13表达量显著高于癌旁组织(P<0.001)。以CD13相对表达量中位数(4.25)为界,将患者分为CD13高表达组(59例)和低表达组(58例)。CD13高表达组CEA≥5μg/L、存在脉管浸润、T分期3~4期、N分期2~3期及病理分级3~4级的患者比例显著高于低表达组(均P<0.05);KM生存曲线分析显示,CD13高表达组术后5年生存率显著低于低表达组(P<0.001);KM分析及Cox多因素分析显示,CD13高表达(HR=2.125,95%CI:1.256~3.595)是胃癌患者术后5年生存率的独立危险因素。ROC曲线分析显示,以CD13相对表达量4.22为截点值,预测胃癌患者术后5年死亡的灵敏度为75.71%,特异度为93.62%,准确度为0.881(P<0.001)。结论CD13在胃癌组织中高表达与临床病理参数有关,是患者术后5年生存率的独立危险因素,并对预后评估有一定的预测价值。Objective To analyze the expression of alanyl(membrane)aminopeptidase(CD13)in gastric cancer tissues and its relationship with clinicopathological parameters,and to evaluate its value in predicting the long-term prognosis of patients with gastric cancer.Methods A total of 117 patients who underwent radical gastrectomy in the First Affiliated Hospital of Bengbu Medical College from January 2015 to January 2018 were included.Immunohistochemistry was used to analyze the expression of CD13 in gastric cancer tissues and evaluate the relationship between CD13 and clinicopathological parameters,as well as the predictive value of CD13 on the 5-year postoperative survival rate of patients.Results The expression of CD13 in gastric cancer tissues was significantly higher than that in adjacent tissues(P<0.001).Patients were divided into a high CD13 expression group(n=59)and a low CD13 expression group(n=58)based on the median relative expression of CD13(4.25).The proportion of patients with CEA≥5μg/L,vascular infiltration,T stages 3-4,N stages 2-3,and pathological grade 3-4 in the CD13 high expression group was significantly higher than that in the low expression group(all P<0.05).KM survival curve analysis showed that the 5-year survival rate of patients with high CD13 expression was significantly lower than that of patients with low CD13 expression(P<0.001).KM analysis and Cox multivariate analysis showed that high expression of CD13(HR=2.125,95%CI:1.256-3.595)was an independent risk factor for the 5-year survival rate of gastric cancer patients after surgery.ROC curve analysis showed that with the relative expression level of CD134.22 as the cut-off value,the sensitivity,specificity and accuracy of predicting death 5 years after surgery in gastric cancer patients were 75.71%,93.62%and 0.881(P<0.001).Conclusion CD13 is highly expressed in gastric cancer tissues and is closely related to clinicopathological parameters.It is an independent risk factor for the 5-year postoperative survival rate of gastric cancer patients a

关 键 词：胃癌 CD13 临床病理参数 危险因素分析 生存分析 

分 类 号：R735.2[医药卫生—肿瘤] R730.43[医药卫生—临床医学]