巢蛋白过表达作为胶质母细胞瘤潜在预后标志物的研究  

Nestin overexpression as a potential prognostic marker for glioblastoma

作　　者：曹双 刘江 刘备[2] 程飞飞 Cao Shuang;Liu Jiang;Liu Bei;Cheng Feifei(Center for Neurological Diseases,the Third Affiliated Hospital of Chongqing Medical University,Chongqing 401120,China)

机构地区：[1]重庆医科大学附属第三医院神经疾病中心,401120 [2]重庆医科大学附属大足医院神经外科

出　　处：《中华老年心脑血管病杂志》2024年第10期1162-1166,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：重庆市卫生健康委员会科研项目(2024WSJK100)。

摘　　要：目的 探讨巢蛋白表达与微血管密度(microvessel density,MVD)的关系和作为胶质母细胞瘤(glioblastoma,GBM)潜在预后标志物的价值。方法 回顾性纳入2020年3月至2023年3月在重庆医科大学附属第三医院接受全麻开颅手术的GBM患者50例,根据巢蛋白H评分(巢蛋白染色强度×阳性细胞百分比)中位值将50例患者分为H评分≥80.0分组28例和H评分<80.0分组22例;随访2年,将50例患者分为死亡组23例和存活组27例。用免疫组织化学染色测定组织巢蛋白表达,用血管性血友病因子(von willebrand factor,vWF)和CD105免疫反应法量化MVD;用Spearman秩检验分析巢蛋白表达与MVD形成之间的相关性,用多变量Cox比例风险回归分析GBM患者总生存期恶化的影响因素,用Kaplan-Meier生存曲线分析GBM患者2年生存率。结果 巢蛋白H评分与vWF-MVD(Rho=0.701,P<0.01)、CD105-MVD(Rho=0.753,P<0.01)均呈显著正相关。H评分≥80.0分组和H评分<80.0分组性别、年龄、异柠檬酸脱氢酶-1突变、肿瘤部位、肿瘤位置、脑坏死、肿瘤体积、水肿体积、术前卡氏功能状态评分、肿瘤切除程度比较,差异无统计学意义(P>0.05);存活组异柠檬酸脱氢酶-1突变、肿瘤最大程度切除比例高于死亡组,巢蛋白H评分低于死亡组(P<0.05,P<0.01)。Cox比例风险回归显示,部分切除/活检(HR=4.781,95%CI:2.066~11.060,P=0.001)和巢蛋白H评分升高(HR=1.007,95%CI:1.001~1.013,P=0.032)是GBM患者总生存期恶化的独立影响因素。Kaplan-Meier生存曲线分析显示,巢蛋白H评分≥80.0分组累积生存率低于H评分<80.0分组(log rank χ^(2)=8.147,P=0.004)。结论 巢蛋白过表达与GBM患者的不良预后有关,预示着更多的微血管生成,可能是GBM患者的治疗靶点。Objective To investigate the relationship between nestin expression and microvessel density(MVD) and its value as a potential prognostic marker of glioblastoma(GBM).Methods A retrospective trial was conducted on 50 GBM patients undergoing craniotomy under general anesthesia in the Third Affiliated Hospital of Chongqing Medical University from March 2020 to March 2023.According to the median nestin H score(Nestin staining intensity×percentage of positive cells),they were divided into H score ≥80.0 group(28 cases) and H score<80.0 group(22 cases).After 2 years of follow-up,they were also divided into a death group(23 cases) and a survival group(27 cases).The expression of nestin was determined by immunohistochemical staining,and MVD was quantified by von Willebrand factor(vWF) and CD105 immunohistochemical staining.Spearman rank test was used to analyze the correlation between nestin expression level and MVD formation,multivariate Cox proportional hazards regression analysis was employed to identify the influencing factors for overall survival in the GBM patients,and Kaplan-Meier survival curve was plotted to analyze the 2-year survival rate of the patients.Results The nestin H score was positively correlated with vWF-MVD(Rho=0.701,P<0.01) and CD105-MVD(Rho=0.753,P<0.01).There were no significant differences between the H score ≥80.0 group and the H score <80.0 group in terms of gender,age,isocitric dehydrogenase-1 mutation,tumor site,tumor location,brain necrosis,tumor volume,edema volume,preoperative Karnofsky Performance Status score,and extent of tumor resection(P>0.05).The survival group had larger proportions of isocitrate dehydrogenase-1 mutation and maximal resection,and lower nestin H score than the death group(P<0.05,P<0.01).Cox proportional hazards regression showed that partial resection/biopsy(HR=4.781,95%CI:2.066-11.060,P=0.001) and increased nestin H score(HR=1.007,95%CI:1.001-1.013,P=0.032) were independent influencing factors for worsening overall survival in the GBM patients.Kaplan-Meier surv

关 键 词：胶质母细胞瘤 微血管密度 生存期 预后 

分 类 号：R739.41[医药卫生—肿瘤]