SNX10在神经胶质瘤中的表达及其对预后的影响

Decreased sorting nexin 10 expression predicts poor clinical outcomes of patients with gliomas

目的研究分选连接蛋白10（SNX10）在神经胶质瘤组织中的表达及其与患者预后的关系。方法收集中山大学附属孙逸仙纪念医院神经外科自2007年1月至2012年12月手术切除并经病理确诊的神经胶质瘤标本30例，其中WHO分级低级别（Ⅰ级和Ⅳ级）9例、高级别（Ⅲ级和Ⅳ级）21例。另取30例因脑外伤行内减压术的正常脑组织作为对照组。免疫组化染色检测标本中SNX10的表达，分析其与患者各项临床病理指标及预后的关系。Cox比例风险模型分析胶质瘤患者术后死亡的危险因素。结果胶质瘤组标本中SNX10高表达12例，低表达18例；对照组标本中SNX10高表达25例，低表达5例；胶质瘤组标本中SNX10高表达率低于对照组，差异有统计学意义（P〈0.05）。高级别胶质瘤标本中SNX10高表达率低于低级别胶质瘤标本，差异有统计学意义（P〈0.05）。SNX10高表达胶质瘤患者的中位生存期为（22.50±8.27）个月，而SNX10低表达患者的中位生存期为（15.50±0.99）个月。SNX10低表达组胶质瘤患者术后生存率低于SNX高表达组胶质瘤患者（34% vs 65%），差异有统计学意义（P〈0.05）。Cox比例风险模型分析结果显示SNX10表达和肿瘤WHO分级是神经胶质瘤患者术后死亡的独立危险因素，SNX10表达减弱，患者发生术后死亡的风险便增加1.983倍（95%可信区间1.602-2.314，P=0.000）。结论SNX10蛋白表达减弱与神经胶质瘤的发生发展有关，对患者的术后生存时间有显著影响，SNX10蛋白表达减弱可能是神经胶质瘤患者术后预后不良的重要指标。

Objective To investigate the sorting nexin 10 （SNX10） expression in glioma tissues and its relationship with prognosis of the patients. Methods Thirty glioma specimens, collected from surgery and conformed by pathology in our hospital fi＇om January 2007 to December 2012, were used in our study, and in them, 9 were WHO grade I and II and 21 were WHO grade III and IV; and 30 nonneoplastic tissue specimens collected during decompression were used as control group. Immunohistochemical staining using polyclonal SNX10 antibody was performed on paraffin embedded specimens. The staining intensity was stratified as absent （-）, weak （＋）, moderate （＋＋） and strong （＋＋＋）. The relationships of SNX10 expression with several clinic pathologic indicators and prognosis were analyzed. Results High SNX10 expression was noted in 12 specimens and low SNX10 expression in 18 specimens of the glioma group. High SNX10 expression was noted in 25 specimens and low SNX10 expression in 5 specimens of the control group; the high SNX10 expression rate in glioma tissues was significantly lower than that in non-neoplastic brain tissues （P〈0.05）; the high SNX10 expression rate in high-grade glioma tissues was significantly lower than that in low-grade glioma tissues （P〈0.05）. The median survival time of glioma patients with high SNX10 expression was 22.50_＋8.27 months, and that of glioma patients with low SNX10 expression was 15.50±0.99 months. The survival rate of glioma patients with low SNX10 expression was significantly lower than that of glioma patients with high SNX10 expression （34% vs. 65%, P〈0.05）. By Cox multi-factor risk scale model, the expression level of SNX10 and grading of tumors were identified as the independent risk factors of patient＇s post-operative death; following the decreased SNX10 expression, the risk of postoperative death increased 1.983 times （95% confidence interval=1.602-2.314, P〈0.05）. Conclusions Decreased SNX10 expression is associated with occurrence and development of gliomas, and has a significant effect on patients＇ post-operative survival time. Decreased SNX10 expression level may be an important index of poor prognosis in glioma patients.