膀胱移行细胞癌患者血cGAS、STING基因表达与癌组织CD44阳性的剂量—效应关系  

Dose-effect relationship between blood cGAS and STING expression and CD44 positivity in cancer tissues of patients with bladder transitional cell carcinoma

作　　者：胡婉彦 汪溢[2] 秦晓燕 郑志昂[1] Hu Wanyan;Wang Yi;Qin Xiaoyan;Zheng Zhiang(Department of Laboratory,Sanya Central Hospital/Hainan Third People's Hospital,Hainan,Sanya 572022,China;不详)

机构地区：[1]三亚中心医院/海南省第三人民医院检验科,572022 [2]三亚中心医院/海南省第三人民医院泌尿外科,572022

出　　处：《疑难病杂志》2025年第2期214-219,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：海南省卫生健康行业科研项目(22A200298)。

摘　　要：目的探讨膀胱移行细胞癌(UCB)患者血环鸟苷酸—腺苷酸合成酶(cGAS)、干扰素基因刺激蛋白(STING)的基因表达与癌组织CD44阳性的剂量—效应关系。方法选取2022年10月—2024年5月海南省三亚中心医院/海南省第三人民医院泌尿外科诊治的UCB患者60例作为研究组,同期膀胱内翻性乳头状瘤患者60例作为对照Ⅰ组,体检健康者60例作为对照Ⅱ组。比较3组血cGAS、STING mRNA表达及研究组、对照Ⅰ组瘤组织肿瘤干细胞标志物CD44表达情况。Spearman秩相关系数分析研究组、对照Ⅰ组血cGAS、STING mRNA表达与组织CD44表达的相关性。研究组根据组织CD44表达分为阳性患者、阴性患者,多因素Logistic回归分析组织CD44阳性的独立危险因素。限制性立方样条图分析血cGAS、STING mRNA表达与组织CD44阳性的剂量—效应关系。结果血cGAS、STING mRNA表达比较,研究组>对照Ⅰ组>对照Ⅱ组(F/P=194.740/<0.001,142.937/<0.001);研究组瘤组织肿瘤干细胞标志物CD44积分、阳性表达率高于对照Ⅰ组(t/χ^(2)/P=18.463/<0.001,67.222/<0.001);研究组血cGAS、STING mRNA表达与组织CD44积分呈中度负相关(r/P=-0.638/<0.001,-0.717/<0.001);对照Ⅰ组血cGAS、STING mRNA表达与组织CD44积分呈低度负相关(r/P=-0.299/0.020,-0.291/0.024);研究组CD44阳性患者体质量指数、低分化比率、浸润深度T3~4比率、淋巴结转移比率大于阴性患者,血cGAS、STING mRNA表达低于阴性患者;浸润深度T3~4、淋巴结转移是组织CD44阳性的独立危险因素[OR(95%CI)=2.558(1.289~5.076),2.870(1.313~6.275)],血cGAS、STING mRNA升高是组织CD44阳性的独立保护因素[OR(95%CI)=0.673(0.518~0.874),0.696(0.529~0.915)];血cGAS、STING mRNA表达与组织CD44阳性间存在非线性剂量—效应关系,当血cGAS mRNA>2.15、血STING mRNA>1.75时,组织CD44阳性的风险显著降低。结论UCB患者血cGAS、STING mRNA表达增加,二者显著增加时对UCB组织CD44表达具有抑制作用。Objective To explore the dose-effect relationship between the expression of cyclic GMP-AMP synthase(cGAS)and stimulator of interferon genes(STING)in the blood of patients with urothelial carcinoma of the bladder(UCB)and the positivity of CD44 in cancer tissues.Methods Sixty patients with UCB in our hospital from October 2022 to May 2024 were selected as the study group,60 patients with inverted papilloma of bladder during the same period were selected as control groupⅠ,and 60 healthy patients were selected as control groupⅡ.The expression of cGAS and STING in blood of the 3 groups and the expression of CD44,a tumor stem cell marker,in the study group and control groupⅠwere compared.Spearman rank correlation coefficient was used to analyze the correlation between blood cGAS and STING expression and tissue CD44 expression in study group and control groupⅠ.The study group divided CD44 expression into positive patients and negative patients and analyzed the independent risk factors of CD44 positive tissues by multiple Logistic regression.The dose-effect relationship between expression of cGAS and STING in blood and positive CD44 in tissue was analyzed by restricted cubic spline diagram.Results The expression of cGAS and STING in the study group was higher than that in control groupⅠand control groupⅡ,and that in control groupⅠwas higher than that in control groupⅡ(F/P=194.740/<0.001,142.937/<0.001).The score and positive expression rate of CD44 of tumor stem cells in the study group were higher than those in the control groupⅠ(t/χ^(2)/P=18.463/<0.001,67.222/<0.001).The expressions of cGAS(r=-0.638,P<0.001)and STING(r=-0.717,P<0.001)in the study group were moderately negatively correlated with the scores of CD44 in tissues.The expressions of cGAS(r=-0.299,P=0.020)and STING(r=-0.291,P=0.024)expression had low correlation with tissue CD44 score.Lymph node metastasis and depth of tumor invasion were independent risk factor for CD44 positive tissue,and cGAS mRNA and STING mRNA were independent protectiv

关 键 词：膀胱移行细胞癌 环鸟苷酸—腺苷酸合成酶 干扰素基因刺激蛋白 CD44 剂量—效应关系 

分 类 号：R737.14[医药卫生—肿瘤]