脑胶质瘤组织Pax3、P4HA1、Rac1基因表达与全切术后复发的关系及意义

Relationship between expression levels of Pax3,P4HA1,and Rac1 in glioma tissues with the recurrence of glioma after total resection and its significance

目的探讨组织配对盒基因3(Pax3)、脯氨酰4-羟化酶亚基α1(P4HA1)、Rac GTP酶激活蛋白酶1(Rac1)基因表达与脑胶质瘤全切术后复发关系及意义。方法选取2019年3月至2021年6月80例脑胶质瘤全切术患者,根据术后1年是否复发分为复发组、未复发组,比较2组基线资料、组织Pax3、P4HA1、Rac1基因表达,采用Logistic分析脑胶质瘤全切术后复发的相关因素,采用受试者工作特征曲线(receiver operating characteristic,ROC)分析组织Pax3、P4HA1、Rac1基因表达预测复发的价值,并比较不同Pax3、P4HA1、Rac1基因表达水平患者术后复发时间。结果复发组病理分级、术后辅助治疗情况与未复发组比较,差异有统计学意义(P<0.05);复发组组织Pax3 mRNA、P4HA1 mRNA、Rac1 mRNA表达高于未复发组(P<0.05);校正了病理分级、术后辅助治疗情况后,Pax3 mRNA、P4HA1 mRNA、Rac1 mRNA仍是复发的独立相关危险因素(P<0.05);Pax3 mRNA、P4HA1 mRNA、Rac1 mRNA及三者联合预测复发的ROC下面积(area under the curve,AUC)依次为0.840、0.825、0.828、0.940;Pax3 mRNA、P4HA1 mRNA、Rac1 mRNA高水平患者复发时间短于低水平患者(P<0.05)。结论脑胶质瘤组织中Pax3 mRNA、P4HA1 mRNA、Rac1 mRNA表达与全切术后复发及复发时间有关,联合检测可作为早期预测术后复发的一个可靠方案,既能保证高复发风险人群治疗的充分性,又能减少低复发风险人群治疗相关的不良反应,从而最大化患者受益。

Objective To investigate the relationship between the expression levels of pairing box gene 3(Pax3),prolyl 4-hydroxylase subunitα1(P4HA1)and Rac GTPase-activated protease 1(Rac1)in glioma tissues with the recurrence of glioma after total resection relationship and its clinical significance.Methods From March 2019 to June 2021,80 glioma patients treated with total resection were selected,and they were assigned to recurrence group and non-recurrence group according to the 1-year postoperative recurrence condition.The baseline data,and expression levels of Pax3,P4HA1,and Rac1 in glioma tissues were compared.Logistic regression analysis was used to analyze the related factors of recurrence after total resection of glioma.Receiver operating characteristic(ROC)curves were plotted to analyze the value of expression levels of Pax3,P4HA1,and Rac1 in predicting the recurrence of glioma.Postoperative recurrence time in patients with different expression levels of Pax3,P4HA1,and Rac1 were compared.Results There were significant differences in the pathological grade and postoperative adjuvant treatment between recurrence group and non-recurrence group(P<0.05).Expression levels of Pax3,P4HA1 and Rac1 in glioma tissues of recurrence group were significantly higher than those in non-recurrence group(P<0.05).After adjusting pathological grade and postoperative adjuvant therapy,expression levels of Pax3,P4HA1 and Rac1 in glioma tissues were independent risk factors for the recurrence of glioma(P<0.05).Area under the curve of the expression levels of Pax3,P4HA1 and Rac1 and their combination detection in predicting the recurrence of glioma was 0.840,0.825,0.828,and 0.940,respectively.The time to recurrence was significantly shorter in glioma patients expressing high levels of Pax3,P4HA1 and Rac1(P<0.05).Conclusion Expression levels of Pax3,P4HA1 and Rac1 in glioma tissues are related to the recurrence and recurrence time after total resection.A combination detection can be used as a reliable solution for early prediction of postoperative recurrence,which not only ensures the adequacy of treatment in high recurrence risk groups,but also reduces the adverse reactions related to treatment in low recurrence risk groups,thereby maximizing patient benefit.