TRIM28、PDK1及N-cadherin在胰腺癌中的表达和临床意义  

Expressions and clinical signifances of TRIM28,PDK1 and N-cadherin in pancreatic carcinoma

作　　者：燕坤 邱爱燕[2] 薛栋[2] 王平安 蒋彦峰 刘建宇 Yan Kun;Qiu Aiyan;Xue Dong;Wang Ping′an;Jiang Yanfeng;Liu Jianyu(School of Clinical Medicine,Binzhou Medical University,Yantai 264003,China;Department of Hepatobiliary Surgery,Binzhou People′s Hospital,Binzhou 256610,China)

机构地区：[1]滨州医学院临床医学院,烟台264003 [2]滨州市人民医院肝胆外科,滨州256610

出　　处：《国际外科学杂志》2024年第10期682-687,F0003,共7页International Journal of Surgery

基　　金：山东省自然科学基金项目(ZR2022MH303);中国高校产学研创新基金-华通国康医学科研专项(2023HT049);山东省医药卫生科技发展计划项目(202104010675,202004011131);滨州市人民医院院级课题(YBKTZR202105,XJ2022007708)。

摘　　要：目的探讨三结构域蛋白家族28(TRIM28)、3-磷酸肌醇依赖性蛋白激酶-1(PDK1)及N-钙黏蛋白(N-cadherin)在胰腺癌中的表达和临床意义。方法选取2009年1月—2022年11月于滨州市人民医院肝胆外科诊断为胰腺癌行根治性切除术并送检的病理标本72例,病理诊断均为胰腺导管腺癌(PDAC)。应用免疫组化法检测TRIM28、PDK1及N-cadherin在72例胰腺癌和癌旁组织中的表达,探索三者的表达与胰腺癌各临床病理特征的相关性,并分析三者的表达及临床病理特征对患者预后的影响。计数资料以例数和百分比[例(%)]表示,组间比较采用χ^(2)检验。相关性分析采用Spearman法;生存分析采用Kaplan-Meier法,生存率的比较采用Log-rank检验;影响患者生存预后的危险因素采用单因素和多因素Cox回归分析。结果PDAC中TRIM28(72.22%)、PDK1(65.28%)及N-cadherin(61.11%)的阳性率均显著高于癌旁组织(26.39%、33.33%、34.72%),并且三者高表达的患者具有分化程度较低、分期较晚、有淋巴结转移等特点(P<0.05);TRIM28与PDK1及N-cadherin在PDAC中的表达均呈正相关(r=0.720,P<0.001;r=0.714,P<0.001);N-cadherin与PDK1在PDAC中的表达也呈正相关(r=0.854,P<0.001);Kaplan-Meier生存曲线分析结果显示,TRIM28、PDK1及N-cadherin阳性患者的2年生存率(13.46%、14.89%、13.64%)显著低于阴性患者(50.00%、40.00%、39.29%),差异均具有统计学意义(P<0.05);单因素Cox回归分析结果显示,肿瘤中低分化、伴有神经浸润和淋巴结转移、TNM分期Ⅲ+Ⅳ期、TRIM28阳性、PDK1阳性和N-cadherin阳性患者术后2年内的死亡风险显著升高(P<0.05);多因素Cox回归分析结果显示,肿瘤中低分化、伴有神经浸润、TNM分期Ⅲ+Ⅳ期和TRIM28阳性是导致PDAC患者不良预后的独立危险因素(P<0.05)。结论TRIM28、PDK1及N-cadherin在PDAC中高表达且表达水平与PDAC恶性程度明显相关,TRIM28是影响PDAC患者预后的独立危险因素。ObjectiveTo explore the expressions and clinical significances of tripartite motif-containing protein 28(TRIM28),3-phosphoinositide-dependent protein kinase-1(PDK1),and N-cadherin in pancreatic carcinoma.MethodsA total of 72 patients diagnosed with pancreatic carcinoma underwent radical resection in the Department of Hepatobiliary Surgery,Binzhou People′s Hospital from January 2009 to November 2022 were selected,all of which were pathologically diagnosed as pancreatic ductal adenocarcinoma(PDAC).Immunohistochemistry was used to detect the expression of TRIM28,PDK1,and N-cadherin in 72 cases of pancreatic carcinoma and paracancerous tissues,to explore the correlation between the expression of them and the clinicopathological features of pancreatic carcinoma,and to analyze the influence of their expression and clinicopathological characteristics on the prognosis of patients.The count data were expressed as the number of cases and percentage,and the Chi-square test was used for comparison between groups.Spearman method was used for correlation analysis.Kaplan-Meier method was used for survival analysis,and Log-rank test was used to compare the survival rate,and univariate and multivariate Cox regression analysis were used to analyze the risk factors affecting prognosis.ResultsThe positive rates of TRIM28(72.22%),PDK1(65.28%)and N-cadherin(61.11%)in PDAC were significantly higher than those in para-cancerous tissues(26.39%,33.33%,34.72%).Moreover,the patients with high expression of the three had the characteristics of low differentiation,late stage,and lymph node metastasis(P<0.05).TRIM28 was positively correlated with PDK1 and N-cadherin expression in PDAC(r=0.720,P<0.001;r=0.714,P<0.001),N-cadherin and PDK1 expression in PDAC was also positively correlated(r=0.854,P<0.001).Kaplan-Meier survival curve showed that the 2-year survival rate of patients with positive TRIM28,PDK1 and N-cadherin(13.46%,14.89%,13.64%)was significantly lower than that of patients with negative tumor(50.00%,40.00%,39.29%),the differences

关 键 词：胰腺肿瘤 三结构域蛋白家族28 3-磷酸肌醇依赖性蛋白激酶-1 N-钙黏蛋白 免疫组织化学 

分 类 号：R735.9[医药卫生—肿瘤]