非小细胞肺癌组织中AKR1C3水平及其临床意义

Expression of AKR1C3 and clinical significance in non-small cell lung cancer

目的探讨非小细胞肺癌(NSCLC)组织中醛酮还原酶1 C3(AKR1C3)表达及其临床意义。方法收集2013年1月至2016年3月88例手术切除的NSCLC组织及83例癌旁正常组织,采用实时荧光定量PCR(QPCR)法检测上述组织中的AKR1C3表达水平,分析AKR1C3表达与NSCLC临床病理参数(性别、年龄、TNM分期、肿瘤大小、组织学类型及淋巴结转移)的关系;根据随访资料分析AKR1C3表达与预后的关系,采用受试者工作特征曲线(ROC)评价AKR1C3表达在NSCLC早期诊断中的效能。结果 NSCLC组AKR1C3表达水平为0.187±0.175,低于癌旁正常组织的1.079±0.384,差异有统计学意义(P<0.05);AKR1C3诊断NSCLC的曲线下面积为0.982(95%CI:0.966~0.998)。AKR1C3表达与NSCLC性别、年龄、组织学类型及淋巴结转移无关,与肿瘤大小及TNM分期有关。肿瘤大小>3 cm的AKR1C3表达量为0.095±0.055,低于肿瘤大小≤3 cm的0.340±0.201,而Ⅲ、Ⅳ期的AKR1C3表达量为0.094±0.058,低于Ⅰ、Ⅱ期的0.265±0.202,差异有统计学意义(P<0.05)。全组NSCLC患者的中位总生存期(OS)为17.60个月。AKR1C3高表达者的中位OS为20.60个月,高于低表达者的11.90个月,差异有统计学意义(P<0.05);Ⅰ+Ⅱ期患者的中位OS为21.65个月,高于Ⅲ+Ⅳ期的16.20个月,差异有统计学意义(P<0.05);肿瘤大小≤3 cm者的中位OS为18.40个月,高于>3 cm者的15.70个月,差异有统计学意义(P<0.05)。结论 AKR1C3在NSCLC组织中表达降低,且与TNM分期、肿瘤大小及预后有关,可能与NSCLC发生发展有关,在NSCLC诊断及病情评估有一定价值。

Objective To investigate the expression of C3 subtype of aldosterone reductase family 1 （AKR1C3） in non-small cell lung cancer （NSCLC） and its clinical significance. Methods Eighty-eight cases of surgically resected NSCLC tissues and 83 ca- ses of paraneoplastic normal tissues were collected from January 2013 to March 2016. The expression of AKR1C3 in the tissues were de- tected by real-time quantitative PCR （QPCR） , and the expression of AKR1C3 in NSCLC tissues and adjacent normal tissues were compared. The relationship between the expression of AKR1 C3 in NSCLC tissue and the clinicopathological parameters of NSCLC （sex, age, TNM stage, tumor size, histological type, lymph node metastasis） was analyzed. Based on the follow-up data, the relationship be- tween the AKR1C3 and the prognosis was analyzed. The receiver operating characteristic curve （ROC） was used to evaluate the effec- tiveness of AKR1C3 in the early diagnosis of NSCLC. Results The expression of AKR1C3 in the NSCLC group was （0. 187±0. 175） , lower than that in the adjacent normal tissues （ 1. 079±0. 384） , and the difference was statistically significant （P〈0. 05 ）. The area under the NSCLC curve of tissue AKR1C3 was 0. 982 （95%CI： 0. 966-0. 998）. The expression of AKR1C3 in NSCLC tissue were in- dependent of sex, age, histological type and lymph node metastasis, but related with tumor size and TNM staging. The expression of AKR1C3 in tissue more than 3 cm was （0. 095±0. 055） , lower than （0. 340±0. 201） in tissue less than 3 cm （P〈0. 05）. The expres- sion of AKR1C3 in tissue of m and 1V was （0. 094±0. 058） , lower than （0. 265±0. 202） in tissue of I and I1 stage. The median OS of the whole group was 17.60 months. The median OS of the patients with AKR1C3 high level was 20. 60 months, higher than that of the lower level 11.90 months, and the difference was statistically significant （P〈0. 05）. Conclusion The expression of AKR1C3 in NSCLC tissue is decreased, and it is related to TNM stage, tumor size and prognosis. It may be related to the occurrence and develop- ment of NSCLC, and is valuable in NSCLC diagnosis and disease evaluation.