Ⅱ期结肠癌患者术后化疗后液泡型ATP合酶的表达及临床意义

The overexpression of vacuole type ATP synthase predicts poor prognosis in stage II colon cancer patients undergoing postoperative chemotherapy

目的探讨液泡型ATP合酶（V-ATPase）表达与术后辅助化疗的Ⅱ期结肠癌患者临床病理特征关系及其临床意义。方法分别从复发组和未复发组患者中随机选取30例Ⅱ期结肠癌组织和配对癌旁组织，采用反转录-聚合酶链反应（RT-PCR）和实时定量聚合酶链反应（Real-timePCR）检测V-ATPase基因的mRNA表达量，用免疫组织化学EnVinsion法检测V-ATPase基因在化疗后71例未复发患者和35例复发患者癌组织及相应癌旁正常组织中的蛋白表达量。采用χ2检验比较计数资料之间差异，通过COX比例风险模型评估风险。结果复发组和未复发组癌组织中V-ATPasemRNA的平均表达量分别是7．45、2．52（r=14．39，P〈0．01）。免疫组织化学结果显示V-ATPase在复发和未复发患者癌组织中阳性表达率为分别为94．3％（33／35）、50．7％（36／71）（χ2=19．60，P〈0．01）。V-ATPase过表达者术后化疗后5年无瘤生存率和总体生存率均降低。结论V-ATPase基因是影响Ⅱ期结肠癌术后化疗患者生存率的独立预后因素，可能是评估Ⅱ期结肠癌复发风险的高危因素。

Objective To explore the relationship of clinical pathological features and its signifi- cance between vacuole type ATP synthase （V -ATPase） expression and postoperative adjuvant chemother- apy of patients with stage lI colon cancer. Methods We randomly selected 30 patients with stage Ⅱ co- lon cancer tissues and matched tissues adjacent to carcinoma respectively from relapse group and non -re- lapse group. Real - time quantitative polymerase chain reaction （ Real - time PCR） were used to detect the mRNA expression of V - ATPase. Immunohistochemical EnVinsion method was used to detect the V - ATPase protein expression in the carcinoma and adjacent tissues 71 patients did not relapse and 35 re- lapsed patients after postoperative chemotherapy. Chi - square test/Fisher＇ s exact test and Cox proportional hazard model were used to analysis. Results The average expression level of V - ATPase mRNA in 30 tumor recurrent and non - recurrent patients of V - ATPase are respectively 7.45, 2. 52 （χ2 = 14. 39 P 〈 0. 01 ）. Immunohistochemical results showed that the positive expression rate of V - ATPase in recurrent and non - recurrent patients tissues were 94. 3% （ 33/35 ）, and 50. 7% （36/71） （χ2 = 19.60, P 〈 0. 01 ）. Patients with V - ATPase overexpression had poor 5 - year disease - free survival rate and overall survival hazard ratio （HR）. Conclusion V -ATPase is an independent prognostic factor affecting the survival of patients with stage Ⅱ colon cancer patients receiving postoperative chemotherapy.