程序性细胞死亡因子4在肝癌组织的表达及其临床意义  

Expression of programmed cell death 4 in liver cancer tissues and its clinical diagnostic value

作　　者：卓亚 游焜[2] 王昕红[1] 吴虹杰[1] 周艳彩[1] 魏晓霞[1] Zhuo Ya;You Kun;Wang Xinhong;Wu Hongjie;Zhou Yancai;Wei Xiaoxia(Department of Infectious Disease,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China;Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China)

机构地区：[1]新乡医学院第一附属医院感染科,新乡453000 [2]新乡医学院第一附属医院肝胆外科,新乡453000

出　　处：《中华实验外科杂志》2024年第6期1270-1273,共4页Chinese Journal of Experimental Surgery

基　　金：河南省科技攻关计划项目(SB201901062)。

摘　　要：目的探讨程序性细胞死亡因子4(PDCD4)在肝癌组织中表达及其临床诊断价值。方法选取2021年6月到2023年6月新乡医学院第一附属医院手术切除的肝癌组织和癌旁组织作为研究对象,采用蛋白质组学分析肝癌组织中差异表达的蛋白;采用荧光定量聚合酶链反应(PCR)和蛋白质免疫印迹分析癌旁组织和肝癌组织PDCD4表达水平;采用全自动生化仪检测肝癌患者血清肿瘤标志物糖类抗原199(CA199)与甲胎蛋白(AFP)的水平;分析PDCD4表达水平与肝癌患者临床病理特征和预后的关系,并分析PDCD4与肿瘤标志物CA199与AFP的关系。制备接收者工作曲线,分析PDCD4诊断肝癌的价值。符合正态分布的计量数据比较采用独立样本t检验。结果双向电泳结果显示肝癌组织和癌旁组织差异表达的蛋白54个,其中上调20个,下调24个。下调最为显著的蛋白是PDCD4。肝癌组织中PDCD4蛋白和mRNA表达水平(0.85±0.24、0.85±0.24)明显低于癌旁组织(1.57±0.29、1.06±0.26),差异均有统计学意义(t=18.710、17.460,P<0.05)。中高分化患者、未淋巴结转移患者PDCD4表达水平(1.09±0.16、1.17±0.23)明显高于低分化和淋巴结转移(0.74±0.13、0.75±0.15),差异有统计学意义(t=11.410、10.720,P<0.05)。PDCD4高表达组患者3年生存率[55.56%(30/54)]明显高于低表达组[35.56%(16/45)],差异有统计学意义(LogRank=5.649,P<0.05)。高表达组患者血清CA199与AFP水平[(40.67±8.23)U/ml、(55.72±14.79)μg/L]明显低于低表达组患者[(83.94±13.58)U/ml、(58.44±7.72)μg/L],差异有统计学意义(t=11.570、6.990,P<0.05)。PDCD4、CA199与AFP联合诊断的曲线下面积0.850(0.724~0.985),灵敏度为0.895,特异性为0.879。结论肝癌患者肿瘤组织中PDCD4表达显著下调,与患者不良临床病理特征和预后相关,与血清标志物CA199和AFP联合检测有助于肝癌诊断。Objective To investigate the expression of programmed cell death 4(PDCD4)in liver cancer tissues and its clinical diagnostic value.Methods Liver cancer tissues and adjacent tissues surgically removed from June 2021 to June 2023 in our hospital were selected as the research objects.The differentially expressed proteins in liver cancer tissues were analyzed by proteomics.The expression levels of PDCD4 in adjacent tissues and liver cancer tissues were analyzed by fluorescence quantitative polymerase chain reaction(PCR)and Western blotting.The serum levels of tumor markers[carbohydrate antigen 199(CA199)and alpha fetal protein(AFP)]in patients with liver cancer were detected by automatic biochemical analyzer.The relationship between the expression level of PDCD4 and the clinicopathological characteristics and prognosis of patients with liver cancer was analyzed,and the relationship between PDCD4 and tumor markers(CA199 and AFP)was analyzed.The receiver operating characteristic(ROC)curve was prepared to analyze the value of PDCD4 in the diagnosis of liver cancer.Measurement data conforming to normal distribution were compared using Independent Samples t test.Results The results of two-dimensional electrophoresis showed that 54 proteins were differentially expressed in liver cancer tissues and adjacent tissues,among which 20 were up-regulated and 24 were down-regulated.The most significant down-regulated protein was PDCD4.The expression levels of PDCD4 protein and mRNA in liver cancer tissues(0.85±0.24,0.85±0.24)were significantly lower than those in adjacent tissues(1.57±0.29,1.06±0.26,t=18.710,17.460,P<0.05).The expression levels of PD-L1 in moderately well-differentiated patients and patients without lymph node metastasis(1.09±0.16,1.17±0.23)were significantly higher than those in poorly differentiated patients and patients with lymph node metastasis(0.74±0.13,0.75±0.15,t=11.410,10.720,P<0.05).The 3-year survival rate of patients with high expression of PD-L1[55.56%(30/54)]was significantly higher than that

关 键 词：程序性细胞死亡因子4 肝癌 临床病理特征 预后 肿瘤标志物 

分 类 号：R735.7[医药卫生—肿瘤]