基于生物信息学构建膀胱癌预后风险预测模型及临床价值分析  

Adverse prognosis risk prediction model of bladder cancer based on bioinformatics and its clinical value analysis

作　　者：郭青鑫 张福华 张雪娇 姜丽丽 GUO Qingxin;ZHANG Fuhua;ZHANG Xuejiao;JIANG Lili(Department of Urology,Hongqi Hospital Affiliated to Mudanjiang Medical College,Heilongjiang Mudanjiang 157011,China;Department of Emergency,Hongqi Hospital Affiliated to Mudanjiang Medical College,Heilongjiang Mudanjiang 157011,China;Intensive Care Unit,Hongqi Hospital Affiliated to Mudanjiang Medical College,Heilongjiang Mudanjiang 157011,China)

机构地区：[1]牡丹江医学院附属红旗医院泌尿外科,黑龙江牡丹江157011 [2]牡丹江医学院附属红旗医院急诊科,黑龙江牡丹江157011 [3]牡丹江医学院附属红旗医院重症监护室,黑龙江牡丹江157011

出　　处：《现代肿瘤医学》2024年第8期1474-1479,共6页Journal of Modern Oncology

摘　　要：目的:基于生物信息学分析,探讨7-脱氢胆固醇还原酶(7-dehydrocholesterol reductase,DHCR7)、非红细胞血影蛋白β2(non-erythrocytic 2,SPTBN2)在膀胱癌(bladder cancer,BLCA)中的表达特征,并分析其作为BLCA不良预后预警模型的临床应用价值。方法:通过基因表达谱数据动态分析(Gene Expression Profiling Interactive Analysis,GEPIA)网站评估DHCR7、SPTBN2在BLCA中的表达特征;Kaplan-Meier Plotter在线网站分析DHCR7和SPTBN2表达与BLCA患者总生存率的关系。进一步,选取2018年1月至2019年12月在本院收治的78例BLCA为研究对象,免疫组织化学法检测组织中DHCR7、SPTBN2的表达并分析与BLCA临床病理特征的关系;多因素Logistic回归模型对BLCA不良预后的危险因素进行分析,构建预警模型并转化为风险评分系统;受试者工作特征(receiver operating characteristic,ROC)曲线和Hosmer-Lemeshow(H-L)检验评估模型的诊断效能和拟合度;10-折交叉法对模型内部和外部进行验证。结果:GEPIA在线网站提示,BLCA组织中DHCR7和SPTBN2表达水平高于正常对照组(P<0.05);DHCR7和SPTBN2在BLCA患者Ⅳ期中的表达较Ⅱ期增加(P分别为0.00191,0.0062);随着DHCR7和SPTBN2表达水平增加,患者的生存率降低(Logrank P分别为0.0031,0.0015)。DHCR7、SPTBN2表达在不同TNM分期、肿瘤分化程度及淋巴结转移的患者中比较,差异有统计学意义(χ^(2)=6.167,5.080,5.092;χ^(2)=8.621,4.807,4.734,均P<0.05);且TNMⅢ-Ⅳ期、低分化程度、有淋巴结转移以及DHCR7、SPTBN2高表达是BLCA不良预后的危险因素(P<0.05)。构建模型组ROC曲线下面积(AUC)为0.889,H-L检验拟合较好(χ^(2)=6.0899,P=0.2976);验证组AUC为0.883,H-L检验拟合较好(χ^(2)=9.2649,P=0.0990)。结论:基于DHCR7和SPTBN2构建的BLCA不良预后风险预警模型诊断效能较好,可为BLCA不良预后预测提供重要的参考价值。Objective:Based on bioinformatics analysis,to explore 7-dehydrocholesterol reductase(DHCR7)and non-erythrocytic 2(SPTBN2)expression characteristics in bladder cancer(BLCA),and analyze its clinical application value as an early warning model of poor prognosis in BLCA.Methods:The expression characteristics of DHCR7 and SPTBN2 in BLCA tissues were evaluated using the Gene Expression Profiling Interactive Analysis(GEPIA)website.The Kaplan-Meier Plotter online website analyzed the relationship between the expression of DHCR7 and SPTBN2 and the overall survival rate of BLCA patients.Furthermore,78 cases of BLCA admitted to our hospital from January 2018 to December 2019 were selected as the research subjects.The expression of DHCR7 and SPTBN2 in the tissues was detected using immunohistochemistry and the relationship with the clinical and pathological characteristics of BLCA was analyzed.A multivariate Logistic regression model was used to analyze the risk factors for poor prognosis in BLCA,and an early warning model was constructed and transformed into a risk scoring system.Evaluate the diagnostic efficacy and fitting degree of the model using the receiver operating characteristic(ROC)curve and Hosmer-Lemeshow(H-L)test.The 10-fold cross method verifies both the internal and external aspects of the model.Results:The GEPIA online website showed that the expression levels of DHCR7 and SPTBN2 proteins in BLCA tissues were higher than those in the normal control group(P<0.05).The expression of DHCR7 and SPTBN2 in BLCA patients in stage Ⅳ was significantly increased compared to stage Ⅱ(P=0.00191,0.0062,respectively).As the expression levels of DHCR7 and SPTBN2 increased,the survival rate of patients decreased(Logrank P is 0.0031,0.0015,respectively).The expression of DHCR7 and SPTBN2 was statistically significant in patients with different TNM stages,tumor differentiation,and lymph node metastasis(χ^(2)=6.167,5.080,5.092;χ^(2)=8.621,4.807,4.734,all P<0.05).TNM stage Ⅲ-Ⅳ,poor differentiation,lymph node metastasis,h

关 键 词：膀胱癌 7-脱氢胆固醇还原酶 非红细胞血影蛋白β2 不良预后 预警模型 

分 类 号：R737.14[医药卫生—肿瘤]