胰腺导管腺癌TPAP基因的表达及其与临床病理和预后的关系

Relationship between the expression of TPAP gene in pancreatic ductal cancer and its clinical features and prognosis

目的探讨胰腺导管腺癌组织中TPAP基因表达与患者临床特征及预后之间的关系。方法采用实时定量RT-PCR方法检测40例胰腺导管腺癌、相应的癌旁胰腺组织及5例尸检获得的正常胰腺组织中TPAPmRNA的表达情况,并分析TPAP基因检测结果与临床病理参数和预后之间的关系。结果 TPAP在胰腺癌组织中的相对表达量[0.012(0.004,0.018)]明显低于癌旁组织[0.018(0.009,0.081)]及正常胰腺组织[0.740(0.457,0.891),P<0.01],后两者之间表达也有明显差异(P<0.001)。癌组织中TPAPmRNA的相对表达量与远处转移呈负相关(r=-0.342,P=0.031),与高分化呈正相关(r=0.371,P=0.018),但肿瘤部位和大小、血清CA19-9浓度、血清CEA浓度、临床分期、淋巴转移、患者的性别和年龄均对TPAP表达无明显影响(P>0.05)。随访发现TPAP阴性为生存期的危险因素,阳性表达为生存期的保护因素。结论 TPAP对胰腺癌的发生、发展可能具有抑制作用,其高表达可作为胰腺癌生存期长的良性预测指标。

Objective To investigate the relationship between the expression of TPAP gene in pancreatic duetal adeno-carcinoma and its clinical features and prognosis.Methods The total RNA were extracted from 40tissue samples of pancreatic ductal adeno-carcinoma and corresponding adjacent pancreatic tissues,as from well as 5normal pancreatic tissues from autopsy.TAQMAN real-time PCR（RT-PCR）was used to detect the TPAP expression.The relationship between TPAP expression in pancreatic carcinoma tissues and the clinical pathologic parameters were analyzed.The Kaplan-Meier analysis was adopted to assess the relationship between prognosis and TPAP gene expression.Results The relative quantities（RQs）of TPAP mRNA in pancreatic carcinoma tissues[0.012（0.004,0.018）]were significantly lower than those in the corresponding adjacent pancreatic tissues[0.018（0.009,0.081）]and normal pancreatic tissues[0.74（0.457,0.891）, P〈0.01].There were also significant differences between the latter two tissues（P〈0.001）.The RQs of TPAP mRNA expression in pancreatic carcinoma tissues was negatively correlated with metastasis（r=-0.342,P=0.031）,but positively correlated with pathological grades（r=0.371,P=0.018）.However,the other clinical pathologic findings including tumor site,tumor size,serum CA19-9,serum CEA, TMN stage,lymphatic metastasis,age and gender had no influence on the TPAP mRNA expression（P〉0.05）.What was more important, the results of Kaplan-Meier analysis showed that patients with high TPAP mRNA expression survived significantly longer than those with the low expression（P=0.004）.Conclusion The TPAP mRNA expression may suppress the pancreatic carcinoma development,and its high expression may be a positive predictor of long-term survival of pancreatic carcinoma patients.