Hedgehog信号通路在脑胶质瘤的表达及其预后意义

Hedgehog signal pathway in gliomas and its prognostic significance

目的 观测Hedgehog信号通路在脑胶质瘤的表达,探讨其表达在脑胶质瘤的预后意义.方法 选取118例原发性脑胶质瘤患者的手术切除标本,运用免疫组织化学方法检测Sonic hedgehog（Shh）、受体Patched（Ptch）及下游转录因子Gli1的表达,采用Kaplan-Meier生存分析和Cox比例风险回归模型评价脑胶质瘤患者的预后.结果 免疫染色结果显示Shh、Ptch和Gli1的阳性表达率随胶质瘤病理等级升高呈增强趋势（P＜0.01） 随KPS评分的下降而成增强趋势（P＜0.01）.生存分析表明,阳性表达Shh、Ptch和Gli1的胶质瘤患者总体存活率低于三者不表达的患者（P＜0.01）.多因素Cox分析显示KPS（P＜0.05）、WHO grade（P＜0.01）、Shh（P＜0.05）、Ptch （P＜0.05）和Gli1（P＜0.05）是影响脑胶质瘤预后的独立因素.结论 脑胶质瘤的Shh-Ptch1-Gli1 信号通路处于激活状态,与脑胶质瘤的临床病理特征及预后参数密切相关,提示Hedgehog信号通路的活化在脑胶质瘤的恶性潜能和患者的生存时间起重要的预示作用.

Objective Study the expression of Hedgehog signal channel in glioma, trying to find the signification of its expression to the prognosis of patient. Methods Immunohistochemical staining was done on 118 samples of glioma resection, expression of sonic hedgehog （Shh）, its receptor：Patched （Ptch）and downwards transcription factor Gli1, using Kaplan-Meier survive analysis and Cox proportional hazards regression model to estimate the prognosis of patients with glioma. Results The positive expression of Shh/Ptch/Gli1 is higher as the increase of WHO grade of glioma （P 〈0. 01 ） is higher as thc grade of KPS decreased. Survivor analysis showed the survive rate of glioma with positive expression of Shh/Ptch/Gli1 is lower than that without expression （ P 〈0.01 ）. Cox analysis showed KPS （ P 〈 0. 05 ）, WHO grade （ P 〈the prognosis of glioma. Conclusion Positive expression of Shh/Ptch/Glilis in close relation of pathological character and prognosis, the activation of Hedgehog signal channel has a important indication of the level of maglinancy and survive time of the patient.