CSMD1和GPC3在非小细胞肺癌组织中的表达水平及临床预后意义  

Expression and clinical prognostic significance of CSMD1 and GPC3 in non-small cell lung cancer tissues

作　　者：陈易华 罗艳 田强 曾冬梅 许雷 CHEN Yihua;LUO Yan;TIAN Qiang;ZENG Dongmei;XU Lei(Department of Pathology,General Hospital of Western Theater Command PLA,Chengdu,Sichuan 610083,China)

机构地区：[1]中国人民解放军西部战区总医院病理科,四川成都610083

出　　处：《热带医学杂志》2024年第3期387-391,共5页Journal of Tropical Medicine

基　　金：四川省卫生健康委员会医学科技项目(20P123)。

摘　　要：目的 探讨CUB和Sushi多结构域基因1(CSMD1)和磷脂酰肌醇蛋白聚糖3(GPC3)表达水平在非小细胞肺癌(NSCLC)组织中的表达水平及临床预后意义。方法 收集2017年8月-2020年8月中国人民解放军西部战区总医院的108例NSCLC患者癌组织标本(NSCLC组,n=108)及对应癌旁组织标本(癌旁组,n=108)。采用免疫组化法检测CSMD1和GPC3在组织中的表达情况。采用多因素Cox回归分析NSCLC患者预后的影响因素。结果 NSCLC组CSMD1阳性表达率(29.63%)低于癌旁组(69.44%)、GPC3阳性表达率(65.74%)高于癌旁组(26.85%),差异均有统计学意义(χ^(2)=34.244、32.847,P均<0.001)。NSCLC组织不同TNM分期、分化程度、淋巴结转移情况比较,CSMD1和GPC3蛋白阳性表达率差异均有统计学意义(χ^(2)=4.352、9.635、8.227,12.874、6.382、4.675,P均<0.05);TNM分期Ⅲ期、低分化程度和有淋巴结转移的情况下,NSCLC组织CSMD1蛋白阳性表达率较低,GPC3蛋白阳性表达率较高,差异均有统计学意义(P均<0.05)。108例NSCLC患者出院后连续随访3年,83例患者存活,总生存率为76.85%(83/108)。CSMD1阴性患者的3年总生存率(68.42%)低于CSMD1阳性患者(96.88%)、GPC3阴性患者的3年总生存率(94.59%)高于GPC3阳性患者(67.61%),差异均有统计学意义(χ^(2)=10.248、9.996,P均<0.05)。多因素Cox回归分析显示,淋巴结转移(HR=2.208,95%CI:1.390~3.506)、CSMD1阴性(HR=3.691,95%CI:1.834~7.431)、GPC3阳性(HR=3.043,95%CI:1.890~4.900)是NSCLC患者预后的影响因素(P均<0.05)。结论 CSMD1阴性、GPC3阳性、低分化程度、TNM Ⅲ期和淋巴结转移是NSCLC患者预后不良的危险因素;NSCLC组织中CSMD1阳性表达降低和GPC3阴性表达降低会促进肿瘤进展。Objective To explore the expression and clinical prognostic significance of CUB and Sushi multiple domains 1(CSMD1)and glypican-3(GPC3)in non-small cell lung cancer(NSCLC)tissues.Methods Cancer tissue specimens of 108 NSCLC patients(NSCLC group,n=108)and corresponding paracancer tissue specimens(paracancer group,n=108)were collected in the General Hospital of Western Theater Command PLA from August 2017 to August 2020.The expressions of CSMD1 and GPC3 in tissues were detected using immunohistochemistry.Multivariate Cox regression analysis was utilized to verify the prognostic role of CSMD1 and GPC3 expression in NSCLC patients.Results The positive expression rate of CSMD1 in NSCLC group(29.63%)was lower than that in paracancer group(69.44%),and the positive expression rate of GPC3(65.74%)was higher than that in paracancer group(26.85%),and the difference was statistically significant (χ^(2)=34.244,32.847;both P<0.001).The positive expression rates of CSMD1 and GPC3 proteins were significantly different in NSCLC tissues at different TNM stages,differentiation degrees,and lymph node metastasis(χ^(2)=4.352,9.635,8.227;12.874,6.382,4.675;all P<0.05).In the case of TNM stage Ⅲ,poor differentiation and lymph node metastasis,the positive rate of CSMD1 protein expression in NSCLC tissues was lower,and the positive rate of GPC3 protein expression was higher,the differences were statistically significant(all P<0.05).A total of 108 patients with NSCLC were followed up for 3 years after discharge.83 patients survived,and the overall survival rate was 76.85%(83/108).The 3-year overall survival rate of CSMD1 negative patients(68.42%)was lower than that of CSMD1 positive(96.88%)and the 3-year overall survival rate of GPC3 negative patients(94.59%)was higher than that of GPC3 positive patients(67.61%),the differences were statistically significant(χ^(2)=10.248,9.996,both P<0.05).Multivariate Cox regression analysis showed that lymph node metastasis(HR=2.208,95%CI:1.390~3.506),CSMD1 negative(HR=3.691,95%CI:1.834~7.431)and GP

关 键 词：非小细胞肺癌 CUB和Sushi多结构域基因1 磷脂酰肌醇蛋白聚糖3 预后 

分 类 号：R734.2[医药卫生—肿瘤]