摘要
目的探讨巨囊性病液体蛋白15(GCDFP15)、类肌钙蛋白(Calponin)在宫颈癌和癌前病变组织中表达水平及与患者临床病理特征、预后的关系。方法选取2014-09-01-2016-09-30电子科技大学医学院附属绵阳医院·绵阳市中心医院行宫颈活检或手术的151例患者的宫颈石蜡标本和45例癌旁组织标本(距癌周>2 cm,正常组)为研究对象。其中将84例宫颈癌作为宫颈癌组、35例宫颈高级别上皮内病变(HSIL)作为HSIL组、32例宫颈低级别上皮内病变(LSIL)作为LSIL组。免疫组化法检测GCDFP15和Calponin在不同宫颈组织中的表达情况。通过χ^(2)检验分析GCDFP15、Calponin表达与宫颈癌患者临床病理特征的关系。多因素Cox回归分析影响宫颈癌患者预后的关联因素。结果宫颈癌组GCDFP15阳性表达率(76.19%、62.86%、46.87%和0)与Calponin阴性表达率(71.43%、54.29%、43.75%和2.22%)均高于HSIL、LSIL和正常组,差异均有统计学意义,χ^(2)值分别为70.369和57.043,均P<0.001。国际妇产科协会(FIGO)分期为Ⅲ~Ⅳ期、分化程度为低分化和淋巴结转移的宫颈癌患者GCDFP15阳性表达率(89.66%vs 69.09%、88.89%vs 66.67%、94.44%vs 71.21%)与Calponin阴性表达率(89.66%vs 61.82%、88.89%vs 58.33%、94.44%vs 65.15%)均高于Ⅰ~Ⅱ期、中/高分化和无淋巴结转移的宫颈癌患者,差异均有统计学意义,均P<0.05。GCDFP15阴性表达患者的5年生存率(OS;75.00%)高于阳性患者(40.63%);Calponin阴性表达患者的5年OS(40.00%)低于阳性患者(70.83%),差异均有统计学意义,均P<0.05。单因素分析结果显示,Ⅰ~Ⅱ期、中/高分化、无淋巴结转移、GCDFP15阴性、Calponin阳性的宫颈癌患者5年OS高于Ⅲ~Ⅳ期、低分化、淋巴结转移、GCDFP15阳性和Calponin阴性的宫颈癌患者,差异有统计学意义,χ^(2)值分别为5.601、8.402、4.056、7.206和6.523,P值分别为0.018、0.004、0.044、0.007和0.011。多因素Cox回归分析显示,Ⅲ~Ⅳ期(HR=2.36,95%CI:1.35~4.13)、有淋巴结转移(HR=2.22,95%CI:1.32~3.73)、GCDFP15阳性表达(HR=2.63,95%CI:1.40~4.94)和Calponin阴性表达(HR=3.33,95%CI:1.52~7.31)是宫颈癌患者预后的关联因素,χ^(2)值分别为18.546、16.367、21.053和25.361,均P<0.001。结论GCDFP15在宫颈癌组织中以阳性表达为主,而Calponin在宫颈癌组织中以阴性表达为主。GCDFP15阳性表达、Calponin阴性表达与宫颈癌患者的预后不良有关,可作为预测患者预后的生物学指标。
Objective To investigate the expression of macrocystic disease fluid protein 15(GCDFP15)and troponin-like(Calponin)in cervical cancer and precancerous lesions and its relationship with clinicopathological features and prognosis of patients.Methods The cervical paraffin specimens of 151 patients obtained from cervical biopsy or surgery in Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China from September 1,2014 to September 30,2016 were selected as the research objects,of which 84 cases of cervical cancer were in the cervical cancer group and 35 cases of cervical high-grade epithelium squamous intraepithelial lesion(HSIL)were classified as HSIL group,32 cases of cervical low-grade intraepithelial lesions(LSIL)were classified as LSIL group.At the same time,45 cases of adjacent tissues more than 2 cm away from the edge of the tumor were also studied as normal group.The expressions of GCDFP15 and Calponin in different cervical tissues were detected by immunohistochemistry.The relationship between the expression of GCDFP15,Calponin and the clinicopathological characteristics of patients with cervical cancer was analyzed byχ^(2)test.The related factors affecting the prognosis of cervical cancer patients were analyzed by multivariate Cox regression analysis.Results The positive expression rates of GCDFP15(76.19%,62.86%,46.87%and 0)and negative expression rates of Calponin(71.43%,54.29%,43.75%and 2.22%)in cervical cancer group were higher than those in HSIL,LSIL and normal group,and the differences were statistically significant.χ^(2)values were 70.369and 57.043,respectively,P<0.001.According to the International Society of Obstetricians and Gynecologists(FIGO),the positive rate of GCDFP15expression was 89.66%vs 69.09%,88.89%vs 66.67%,94.44%vs 71.21%in patients with low differentiation and lymph node metastasis with stageⅢtoⅣcervical cancer and the negative expression rate of Calponin(89.66%vs 61.82%,88.89%vs 58.33%,94.44%vs 65.15%)were higher than those in stageⅠ-Ⅱ,medium/high differentiation and no lymph node metastasis,with statistical significance(P<0.05).The 5-year survival rate in patients with negative GCDFP15 expression(OS;75.00%)was higher than that of positive patients(40.63%);The 5-year OS of patients with negative Calponin expression(40.00%)was lower than that of patients with positive Calponin expression(70.83%),and the differences were statistically significant(P<0.05).Univariate analysis showed that the 5-year OS of patients with stageⅠ-Ⅱ,medium/high differentiation,no lymph node metastasis,GCDFP15 negative and Calponin positive cervical cancer was higher than that of patients with stageⅢ-Ⅳ,low differentiation,lymph node metastasis,GCDFP15 positive and Calponin negative cervical cancer,and the difference was statistically significant.χ^(2)values were 5.601,8.402,4.056,7.206and 6.523,respectively,and P values were 0.018,0.004,0.044,0.007and 0.011,respectively.Multivariate Cox regression analysis showed that stageⅢ-Ⅳ(HR=2.36,95%CI:1.35-4.13),lymph node metastasis(HR=2.22,95%CI:1.32-3.73)and positive expression of GCDFP15(HR=2.63,95%CI:1.40-4.94)and Calponin negative expression(HR=3.33,95%CI:1.52-7.31)were associated with prognosis of cervical cancer patients,χ^(2)values were 18.546,16.367,21.053and 25.361,respectively,all P<0.001.Conclusion The expression of GCDFP15 protein is mainly positive in cervical cancer tissue,while the expression of Calponin protein is mainly negative in cervical cancer tissue.The positive expression of GCDFP15 and the negative expression of Calponin are related to the poor prognosis of cervical cancer patients.They can be used as biological indicators to predict the prognosis of patients,and have clinical value.
作者
王亮
朱一平
吴小芳
陈群
舒晓芳
WANG Liang;ZHU Yi-ping;WU Xiao-fang;CHEN Qun;SHU Xiao-fang(Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang 621000,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2022年第16期1194-1200,共7页
Chinese Journal of Cancer Prevention and Treatment
基金
四川省医学科研课题计划(S18032)
关键词
巨囊性病液体蛋白15
类肌钙蛋白
宫颈癌
癌前病变
预后
macrocystic disease fluid protein 15
troponin-like
cervical cancer
precancerous lesions
prognosis
作者简介
第一作者:王亮,女,四川达州人,硕士,副主任医师,主要从事妇科的临床研究工作。E-mail:angwliang@126.com;通信作者:舒晓芳,女,四川眉山人,副主任医师,主要从事妇产科的临床研究工作。E-mail:45119326@qq.com
