早期胃癌组织中TK1、STAT1、B7-H4水平变化与ESD手术预后的相关性分析  

Correlation Between Changes in TK1,STAT1 and B7-H4 Levels in Early Gastric Cancer Tissues and Prognosis of ESD Surgery

作　　者：王健 WANG Jian(Department of Gastrointestinal,Hepatobiliary Surgery,Ji’nan Integrated Traditional Chinese and Western Medicine Hospital,Ji’nan City,Shandong Province 271100)

机构地区：[1]山东省济南市中西医结合医院胃肠肝胆外科,271100

出　　处：《医学理论与实践》2024年第14期2354-2358,共5页The Journal of Medical Theory and Practice

摘　　要：目的:探究早期胃癌组织中细胞质胸苷激酶(TK1)、信号传导及转录激活因子1(STAT1)、B7-H4表达情况及与内镜黏膜下剥离术(ESD)手术预后的相关性。方法:选取2017年1月—2019年1月我院120例行ESD治疗的早期胃癌患者,术中均取癌组织和癌旁正常组织(距癌旁>5cm)标本。采用免疫组化法检测癌组织、癌旁正常组织TK1、STAT1、B7-H4表达情况,并比较不同临床特征患者癌组织TK1、STAT1、B7-H4表达情况,分析癌组织TK1、STAT1、B7-H4表达情况与早期胃癌临床特征的关系。ESD术后随访1年,统计术后1年复发/转移情况,比较复发/转移与未复发/转移患者癌组织TK1、STAT1、B7-H4表达情况,通过交互作用分析癌组织TK1、STAT1、B7-H4表达情况对早期胃癌ESD术后复发/转移的作用,并分析其预测早期胃癌ESD术后复发/转移的价值。结果:早期胃癌患者癌组织中TK1、B7-H4阳性率均高于癌旁正常组织,STAT1阳性率低于癌旁正常组织(P<0.05)。不同肿瘤大小、分化程度、浸润深度患者癌组织TK1、STAT1、B7-H4阳性率比较,差异有统计学意义(P<0.05)。癌组织TK1、B7-H4阳性率与早期胃癌肿瘤大小、浸润深度呈正相关,与分化程度呈负相关(P<0.05);STAT1阳性率与早期胃癌肿瘤大小、浸润深度呈负相关,与分化程度呈正相关(P<0.05)。复发/转移患者癌组织TK1阳性率、B7-H4阳性率高于未复发/转移患者,STAT1阳性率低于未复发/转移患者(P<0.05)。在早期胃癌ESD术后复发/转移中癌组织TK1阳性与STAT1阴性、TK1阳性与B7-H4阳性、STAT1阴性与B7-H4阳性呈正向交互作用(P<0.05)。癌组织TK1、STAT1、B7-H4阳性单独预测早期胃癌ESD术后复发/转移的曲线下面积(AUC)分别为0.879、0.702、0.750,联合预测的AUC最大,为0.914,预测敏感度、特异度分别为94.44%、88.42%。结论:早期胃癌患者癌组织中TK1、B7-H4表达明显升高,STAT1表达降低,在预测ESD术后复发/转移方面具有较高�Objective:To investigate the expression of cytoplasmic thymidine kinase(TK1),signal transducer and activator of transcription 1(STAT1),and B7-H4 in early gastric cancer tissues and their correlation with the prognosis of endoscopic submucosal dissection(ESD)surgery.Methods:120 patients with early gastric cancer treated with ESD in our hospital from January 2017 to January 2019 were selected,and specimens of cancer tissue and normal paracancerous tissue(>5cm from the paracancerous side)were taken intraoperatively.Immunohistochemistry was used to detect the expression of TK1,STAT1 and B7-H4 in cancer tissue and normal paraneoplastic tissue,and to compare the expression of TK1,STAT1 and B7-H4 in cancer tissues of patients with different clinical characteristics,and to analyze the relationship between the expression of TK1,STAT1 and B7-H4 in cancer tissues and the clinical characteristics of early gastric cancer.1 year of postoperative follow-up after ESD,recurrence/metastasis was counted 1 year after surgery.To compare the expression of TK1,STAT1 and B7-H4 in cancer tissues of recurrence/metastasis and non-recurrence/metastasis patients,and to analyze the role of TK1,STAT1 and B7-H4 expression in cancer tissues on the recurrence/metastasis of early gastric cancer after ESD by interaction,and to analyze their value in predicting the recurrence/metastasis of early gastric cancer after ESD.Results:The positive rates of TK1 and B7-H4 in cancer tissues of patients with early gastric cancer were higher than those of normal tissues adjacent to cancer,and the positive rate of STAT1 was lower than that of normal tissues adjacent to cancer(P<0.05).The rates of TK1,STAT1 and B7-H4 in cancer tissues of patients with different tumor sizes,differentiation degrees and infiltration depths were statistically significant(P<0.05).The positive rates of TK1 and B7-H4 in cancer tissues were positively correlated with tumor size and infiltration depth of early gastric cancer,and negatively correlated with differentiation degree(P<0.05);an

关 键 词：早期胃癌 细胞质胸苷激酶 信号传导及转录激活因子1 B7-H4 内镜黏膜下剥离术 

分 类 号：R735.2[医药卫生—肿瘤]