14-3-3θ蛋白在远端胆管癌组织中的表达及临床意义分析  

Expression of 14-3-3θ protein in distal cholangiocarcinoma tissue and its clinical significance

作　　者：武峤[1] 马右维 任章勇 叶晓勇 赵昕[1] 贺强[1] Wu Qiao;Ma Youwei;Ren Zhangyong;Ye Xiaoyong;Zhao Xin;He Qiang(Department of Hepatobiliary Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院肝胆外科,北京100020

出　　处：《国际外科学杂志》2023年第12期817-823,F0003,共8页International Journal of Surgery

摘　　要：目的探讨14-3-3θ蛋白在远端胆管癌组织中的表达水平与临床病理特征,并进一步分析不同表达水平患者的远期预后。方法采用回顾性队列研究的方法收集分析首都医科大学附属北京朝阳医院肝胆外科2015年1月—2021年12月行手术切除的135例远端胆管癌患者的临床资料,其中男性86例,女性49例,年龄(65.1±10.1)岁。应用免疫组织化学检测胆管癌组织中14-3-3θ蛋白的表达水平,依据免疫反应评分(IRS)对患者术后病理切片进行评价,通过受试者工作特征(ROC)曲线确定最佳截断值为3.5,此时曲线下面积为0.741,敏感度为73.5%,特异度为71.3%,将患者分为两组:IRS<4为14-3-3θ低表达组(n=81),IRS≥4为14-3-3θ高表达组(n=54),术后采用门诊复查及电话随访相结合的方式随访患者的生存状态。正态分布的计量资料以均数±标准差(x^(-)±s)表示,组间比较采用t检验;非正态分布的计量资料以M(Q_(1),Q_(3))表示,组间比较采用秩和检验。计数资料组间比较采用χ^(2)检验。采用Kaplan-Meier法进行生存分析,生存率比较采用Log-rank检验。将单因素分析中有统计学意义的因素纳入COX比例风险模型进行多因素分析,筛选预后的影响因素。结果14-3-3θ低表达组术前CA19-9、淋巴结转移例数分别为44.3(20.8,132.2)U/mL、28例,14-3-3θ高表达组分别为82.3(43.4,396.9)U/mL、32例,两组相比差异具有统计学意义(P<0.05)。所有患者均定期进行术后电话或返院随访,14-3-3θ低表达组术后中位生存时间为36个月,术后1、2、3年生存率分别为88.9%、66.5%、49.4%,14-3-3θ高表达组术后中位生存时间为13个月,术后1、2、3年生存率分别为53.7%、23.3%、13.3%,两组比较差异有统计学意义(P<0.01)。COX比例风险模型进行多因素分析,CA19-9>37 U/mL(RR=1.970,95%CI:1.186~3.272,P=0.009)、有淋巴结转移(RR=1.681,95%CI:1.035~2.729,P=0.036)和14-3-3θ染色强度≥4(RR=2.438,95%CI:1.546~3.845,P<0.001)的远端�Objective:To explore the expression level and clinicopathological characteristics of 14-3-3θprotein in distal cholangiocarcinoma tissues,and further analyze the long-term prognosis of patients with different expression levels.Methods:A retrospective cohort study was conducted to collect and analyze the clinical data of 135 patients with distal cholangiocarcinoma who underwent surgical resection at the Department of Hepatobiliary Surgery,Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2015 to December 2021,including 86 males and 49 females.(65.1±10.1)years old.Immunohistochemistry was used to detect the expression level of 14-3-3θprotein in cholangiocarcinoma tissue.The postoperative pathological sections of patients were evaluated based on the immune response score(IRS).The optimal cutoff value was determined through the receiver operating characteristic(ROC)curve was 3.5.Currently,the area under the curve was 0.741,the sensitivity was 73.5%,and the specificity was 71.3%.The patients were divided into two groups:IRS<4 was the 14-3-3θlow expression group(n=81),IRS≥4 was the 14-3-3θhigh expression group(n=54).After surgery,the patient′s survival status was followed up through a combination of outpatient review and telephone follow-up.Normally distributed measurement data were expressed as mean±standard deviation(x^(-)±s),and comparisons between groups were made using the t test;non-normally distributed measurement data were expressed as M(Q_(1),Q_(3)),and comparisons between groups were made using the rank sum test.The chi-square test was used to compare enumeration data between groups.Results:The preoperative CA19-9 and lymph node metastasis in the 14-3-3θlow expression group were 44.3(20.8,132.2)U/mL and 28 cases respectively.The preoperative CA19-9 and lymph node metastasis in the 14-3-3θhigh expression group were 82.3(43.4,396.9)U/mL and 32 cases respectively.The difference between the two groups was statistically significant(P<0.05).All patients had regular postoper

关 键 词：胆管肿瘤 预后 免疫组织化学 远端胆管癌 14-3-3θ蛋白 

分 类 号：R735.8[医药卫生—肿瘤]