摘要
目的探究血清细胞间黏附分子1(ICAM-1)、核因子E2相关因子3(NFE2L3)、Kruppel样转录因子17(KLF17)蛋白表达与直肠癌患者肿瘤恶性程度及术后复发的关系。方法回顾性选取2020年6月至2022年6月丽水市人民医院收治的直肠癌患者150例,收集其临床病理及随访资料,所有患者均采用酶联免疫吸附试验进行血清ICAM-1水平检测,采用免疫组织化学染色法检测NFE2L3和KLF17蛋白表达,应用Logistic回归模型分析各临床资料与直肠癌患者肿瘤恶性程度及术后复发的关系。结果150例直肠癌中低分化49例,中高分化101例。低分化组肿瘤分期Ⅲ~Ⅳ期、肿瘤长径≥5 cm、血清癌胚抗原(CEA)及ICAM-1阳性、NFE2L3及KLF17低表达的比例高于中高分化组(P<0.05);肿瘤分期Ⅲ~Ⅳ期、血清CEA及ICAM-1阳性、NFE2L3及KLF17低表达是直肠癌患者肿瘤低分化的独立危险因素(P<0.05);术后连续随访4~24个月,150例患者中术后复发56例。复发组肿瘤分期Ⅲ~Ⅳ期、肿瘤长径≥5 cm、血清CEA及ICAM-1阳性、NFE2L3及KLF17低表达的比例高于未复发组(P<0.05);肿瘤分期Ⅲ~Ⅳ期、血清ICAM-1阳性、NFE2L3及KLF17低表达是直肠癌患者肿瘤复发的独立危险因素(P<0.05)。结论肿瘤分期、肿瘤长径、血清CEA及ICAM-1水平、NFE2L3及KLF17蛋白表达与直肠癌患者肿瘤恶性程度及术后复发有一定关系,Ⅲ~Ⅳ期、血清ICAM-1阳性、NFE2L3及KLF17低表达均为直肠癌患者肿瘤分化程度、复发的影响因素,且血清CEA阳性还是直肠癌低分化的危险因素。
Objective To investigate the relationship between serum intercellular adhesion molecule 1(I-CAM-1),nuclear factor E2-related factor 3(NFE2L3),and Kruppel-like transcription factor 17(KLF17)protein ex-pression and the degree of malignancy of tumours and postoperative recurrence in patients with rectal cancer.Methods One hundred and fifty rectal cancer patients admitted to Lishui People′s Hospital from June 2020 to June 2022 were retrospectively selected,and their clinicopathological and follow-up data were collected.All pa-tients were tested for serum ICAM-1 level by enzyme-linked immunosorbent assay,and NFE2L3 and KLF17 pro-tein expression by immunohistochemical staining,and Logistic regression model was applied to analyse the rela-tionship between the respective relationship between clinical data and the degree of tumour malignancy and post-operative recurrence in rectal cancer patients.Results Among 150 cases of rectal cancer,there were 49 cases of low differentiation and 101 cases of middle and high differentiation.The proportions of tumour stageⅢ-Ⅳ,tumour diameter≥5 cm,serum CEA and ICAM-1 positivity,and low expression of NFE2L3 and KLF17 in the low differ-entiation group were significantly higher than those in the middle and high differentiation group(P<0.05);tumour stageⅢ-Ⅳ,serum CEA and ICAM-1 positivity,and low expression of NFE2L3 and KLF17 were the independent risk factors for tumour hypodifferentiation in rectal cancer patients(P<0.05);postoperative follow-up was 4-24 months consecutively,and there were 56 cases of postoperative recurrence among 150 patients.Tumour stageⅢ-Ⅳ,tumour diameter≥5 cm,serum CEA and ICAM-1 positivity,and low expression of NFE2L3 and KLF17 were higher in the recurrence group than in the non-recurrence group(P<0.05);tumour stageⅢ-Ⅳ,serum ICAM-1 positivity,and low expression of NFE2L3 and KLF17 were the independent risk factors for tumour recurrence in rectal cancer patients(P<0.05).Conclusion Tumour stage,tumour diameter,serum CEA and ICAM-1 levels,NFE2L3 and KLF17 protein expression have a certain relationship with the degree of malignancy of tumours and postoperative recurrence in patients with rectal cancer,and stageⅢ-Ⅳ,serum ICAM-1 positivity,and low ex-pression of NFE2L3 and KLF17 are all influential factors for the degree of tumour differentiation and recurrence in patients with rectal cancer,and serum CEA positivity is also a risk factor for low differentiation of rectal can-cer.
作者
饶志杰
郭景泉
易弼顺
Rao Zhijie;Guo Jingquan;Yi Bishun(Department of Colorectal Surgery,Lishui People′s Hospital,Lishui,Zhejiang 323000,China)
出处
《中国药物与临床》
2025年第8期520-526,F0003,共8页
Chinese Remedies & Clinics
