核糖体S6激酶4在胰腺癌组织中的表达及其对预后评估的价值

Expression level and prognosis evaluation value of ribosomal S6 kinase-4 in pancreatic cancer

目的:探讨核糖体S6激酶4(RSK4)在胰腺癌组织中的表达及其对预后评估的价值。方法:收集2012年4月至2013年4月湖北省谷城人民医院收治的72例胰腺癌患者的临床资料,采用免疫组化法检测胰腺癌组织和癌旁组织RSK4蛋白表达;以患者性别、年龄、糖尿病史、肿瘤发病部位、肿瘤分化程度、淋巴结转移、临床分期等作为观察指标,分析RSK4蛋白与临床资料的关系;再以肿瘤中位生存期作为观察指标,筛选影响胰腺癌患者预后的危险因素。结果:胰腺癌组织RSK4蛋白阳性表达率为23.6%(17/72),癌旁组织RSK4蛋白阳性表达率为52.8%(38/72),胰腺癌组织RSK4蛋白阳性表达率显著低于癌旁组织(χ~2=12.973,P=0.000)。中、低分化胰腺癌组RSK4蛋白阳性率显著低于高分化胰腺癌组(P<0.05),有淋巴结转移组RSK4蛋白阳性率显著低于无淋巴结转移组(P<0.05),Ⅲ~Ⅳ期组RSK4蛋白阳性率显著低于Ⅰ~Ⅱ期组(P<0.05)。单因素分析显示,RSK4蛋白阳性组中位生存时间显著低于阴性组,高分化组中位生存期显著低于中、低分化组,淋巴结转移组中位生存期显著低于无淋巴结转移组,Ⅲ~Ⅳ期组中位生存期显著低于Ⅰ~Ⅱ期组,各组间比较差异具有统计学意义(均P<0.05)。多因素分析显示,RSK4蛋白、肿瘤分化程度、淋巴结转移、临床分期是影响胰腺癌预后的独立危险因素(均P<0.05)。结论:RSK4蛋白在胰腺癌组织表达显著低于癌旁组织,RSK4蛋白阳性率越低患者预后越差,RSK4蛋白可以作为胰腺癌诊断及预后评估的指标之一。

Objective： To explore the expression level and prognosis evaluation value of ribosomal $6 kinase-4 （RSK4） in pancreatic cancer. Methods： Clinical data of 72 cases of pancreatic cancer patients treated in Gucheng People＇s Hospital from April 2012 to April 2013 were selected, RSK4 protein expression level were detected by immunohistochemieal assay in pancreatic cancer tissues and adjacent tissues, by patient sex, age, history of diabetes, tumor location, tumor differentiation, lymph node metastasis and clinical stage as observed index, the relationship between RSK4 protein and clinical data was analyzed. By the median survival time of the tumor as theobservation index, the risk factors for the prognosis of patients with pancreatic cancer were screened. Results： The positive expression rate of RSK4 protein in pancreatic cancer tissue was 23. 6% （ 17/72 ）, and the positive expression rate of RSK4 protein in paracancerous tissues was 52.8% （38/72）, the positive expression rate of RSK4 protein in pancreatic cancer tissue was significantly lower than that in paracancerous tissues （X2 = 12. 973, P = 0. 000）. In poorly differentiated pancreatic cancer group RSK4 protein positive rate was significantly lower than that in well differentiated pancreatic cancer group （ P 〈 0.05 ）, in lymph node metastasis group RSK4 protein positive rate was significantly lower than that in without lymph node metastasis group （ P 〈 0.05 ）, in m - Iv grade group RSK4 protein positive rate was significantly lower than that of I - II grade group （P 〈 0.05 ）. Single factor analysis showed that RSK4 protein in positive group was significantly lower than that in the negative group, the median survival in high differentiation group was significantly lower than that in the middle and low differentiation group, the median survival time of lymph node metastasis group was significantly lower than that of without lymph node metastasis group, and the median survival time in lg IV grade group was significantly lower than that in the I II grade group, the differences between each groups with statistically significant （ all P 〈 0. 05 ）. Multivariate analysis showed that RSK4 protein, tumor differentiation, lymph node metastasis and clinical stage were independent risk factors that influenced the prognosis of pancreatic cancer （ all P 〈 0.05 ）. Conclusion： The expression of RSK4 protein in pancreatic cancer tissue is significantly lower than that in adjacent tissues, the lower the positive rate of RSK4 protein is, the worse prognosis in pancreatic cancer is. RSK4 protein can be used as one of the indicators for the diagnosis and prognosis of pancreatic cancer.