HOXB9与喉癌临床病理特征相关性研究及预后模型构建  

The correlation between HOXB9 and clinicopathological features and development a prognostic model based on laryngeal carcinoma

作　　者：范鑫 陈浪浪 吕金鹏 卞卡 FAN Xin;CHEN Lang-lang;LYU Jin-peng;BIAN Ka(Department of Otolaryngology Head and Neck Surgery,Tangdu Hospital of Air Force Medical University,Xi′an 710038,China)

机构地区：[1]空军军医大学唐都医院耳鼻咽喉头颈外科,陕西西安710038

出　　处：《临床军医杂志》2025年第3期250-255,261,共7页Clinical Journal of Medical Officers

基　　金：陕西省自然科学基础研究计划重点资助项目(2024JC-ZDXM-46)。

摘　　要：目的明确喉癌预后标志物,探讨其与喉癌临床病理特征的关系并构建预后模型,为疾病的早期诊断和预后管理提供理论支持。方法筛选在多个喉癌数据集中共同上调的基因并进行单因素回归分析,明确喉癌预后的关键基因。收集自2010年1月至2019年12月空军军医大学唐都医院耳鼻咽喉头颈外科收治的240例喉鳞状细胞癌标本,利用免疫组织化学染色探究喉癌预后相关基因的表达与喉癌临床病理特征的相关性。使用R语言划分训练集和验证集,利用单因素回归分析、LASSO回归分析及Cox多因素回归分析明确喉癌预后的关键因素并构建训练集的预后模型,使用验证集进行验证。结果17个基因在3个喉癌数据集中上调2倍以上,其中,HOXB9的风险比最大(风险比=1.014,95%可信区间1.001~1.027,P=0.026)。免疫组织化学染色表明,HOXB9表达与喉癌患者临床分期、T分期和病理分级存在相关性(P<0.05)。多因素回归分析表明,年龄、T分期、N分期、HOXB9是喉癌预后的独立危险因素(P<0.05)。根据多因素分析的结果构建列线图,训练集预测喉癌患者1、3、5年存活率的受试者工作特征曲线下面积分别为0.769、0.802和0.820,使用验证集预测1、3、5年存活率的曲线下面积分别为0.948、0.810和0.813。结论本研究筛选了喉癌预后标志物HOXB9,年龄、T分期、N分期及HOXB9是喉癌预后的独立危险因素,基于上述危险因素构建的列线图预测模型可用于喉癌患者的早期诊断和预后管理。Objective To clarify the prognostic markers of laryngeal cancer,explore the relationship between them and clinicopathological features of laryngeal cancer,and construct a prognostic model,so as to provide theoretical support for early diagnosis and prognostic management of the disease.Methods The genes co-upregulated in multiple laryngeal cancer data sets were screened and univariate regression analysis was performed to identify the key genes in laryngeal cancer prognosis.From January 2010 to December 2019,240 laryngeal squamous cell carcinoma specimens admitted to the Department of Otolaryngology and Head and Neck Surgery,Tangdu Hospital of Air Force Medical University were collected.Immunohistochemical staining was used to investigate the correlation between the expression of genes related to prognosis of laryngeal cancer and clinicopathological features of laryngeal cancer.R language was used to divide the training set and validation set.Univariate regression analysis,LASSO regression analysis and Cox multifactor regression analysis were used to identify the key prognostic factors of laryngeal cancer,and the prognostic model of the training set was constructed,and the validation set was used for verification.Results Seventeen genes were upregulated more than two-fold in three laryngeal cancer datasets,among which HOXB9 had the highest hazard ratio(hazard ratio=1.014,95%confidence interval 1.001 to 1.027,P=0.026).Immunohistochemical staining showed that the expression of HOXB9 was correlated with the clinical stage,T stage and pathological grade of laryngeal cancer patients(P<0.05).Multivariate regression analysis showed that age,T stage,N stage and HOXB9 were independent risk factors for prognosis of laryngeal cancer(P<0.05).Based on the results of multivariate analysis,a column graph was constructed.The area under the working characteristic curve of the training set to predict the 1,3 and 5-year survival rate of patients with laryngeal cancer was 0.769,0.802 and 0.820,respectively,and the area under the worki

关 键 词：喉癌 预后标志物 预后模型 危险因素 列线图 

分 类 号：R739.65[医药卫生—肿瘤]