前列腺癌组织SOX7、SOX9表达及其诊断和预后评估价值

Expression of SOX7, SOX9 in prostate cancer and its clinical value in diagnosis and prognosis prediction

目的探讨前列腺癌组织SOX7、SOX9表达水平及其诊断、预后评估的价值。方法采用免疫组织化学染色法检测2011年5月-2015月5月江汉大学附属医院经病理学证实的68例前列腺癌组织和60例前列腺增生组织的SOX7、SOX9蛋白表达,比较SOX7、SOX9与前列腺癌患者临床资料的关系;利用受试者工作特征(receiver operating characteristic,ROC)曲线计算SOX7、SOX9诊断前列腺癌的曲线下面积(area under curve,AUC);Kaplan Meier检验分析SOX7、SOX9表达与前列腺癌患者总体生存率的关系。结果前列腺癌组织SOX7阳性率(37.2%)明显低于前列腺增生组织(78.3%)(χ~2=23.213,P<0.001);前列腺癌组织SOX9阳性率(73.1%)明显高于前列腺增生组织(45.0%)(χ~2=11.224,P<0.001)。Gleason<7分组SOX7阳性率明显高于≥7分组,Ⅰ~Ⅱ期组SOX7阳性率明显高于Ⅲ~Ⅳ期组,无淋巴结转移组SOX7阳性率明显高于淋巴结转移组(P均<0.05)。Gleason≥7分组SOX9阳性率明显高于<7分组,Ⅲ~Ⅳ期组SOX9阳性率明显高于Ⅰ~Ⅱ期组,淋巴结转移组SOX9阳性率明显高于无淋巴结转移组(P均<0.05)。当SOX9的最佳临界值为2.87分时,SOX9诊断Gleason<7分前列腺癌的AUC高于SOX7(P<0.05);当SOX7的最佳临界值为4.12分时,SOX7诊断Gleason≥7分前列腺癌的AUC高于SOX9(P<0.05)。SOX7阳性组总体生存率明显高于SOX7阴性组(45%vs 20%)(χ2=4.438,P=0.035)。SOX9阳性组总体生存率明显低于SOX9阴性组(24%vs 62%)(χ2=4.059,P=0.041)。结论前列腺癌组织中SOX7呈低表达,而SOX9呈高表达,SOX7、SOX9可以作为前列腺癌诊断和预后评估的分子标记物。

Objective To explore the expression of SOX7, SOX9 in prostate cancer and its clinical value in diagnosis and prognosis prediction. Methods The expression of SOX7, SOX9 was detected by immunohistochemistry assay in 68 prostate cancer tissues and 60 hyperplasia prostate tissues, and the relationship between SOX7, SOX9 and clinical data about patients with prostate cancer was analyzed. The diagnostic value of SOX7, SOX9 for prostate cancer was calculated by receiver operating curve, and the correlation between expression of SOX7, SOX9 and over-all survival in prostate cancer was analyzed by Kaplan Meier. Results The overexpression rate of SOX7 was significantly lower in prostate cancer than in hyperplasia prostate（37.2% vs 78.3%, χ~2=23.213, P0.001）. While, the positive-expression rate of SOX9 was significantly higher in prostate cancer than in hyperplasia prostate（73.1% vs45.0%, χ~2=11.224, P〈0.001）. The positive-expression rates of SOX7 and SOX9 in Gleason 7 group were significantly higher than in Gleason ≥ 7 group, and they were significantly higher in Ⅰ-Ⅱ phase group than in Ⅲ-Ⅳ phase group, and also significantly higher in non-lymph node metastasis group than in lymph node metastasis group with statistically significant differences（all P〈0.05）. When the critical threshold of SOX9 was 2.87, the AUC value of SOX9 was higher than SOX7. However, when the critical threshold of SOX7 was 4.12, the AUC value of SOX7 was higher than SOX9. The over-all survival in the SOX7 negativeexpression group was remarkably higher than SOX7 positive-expression group（45% vs 20%, χ^2=4.438, P =0.035）. The overall survival in the SOX9 negative-expression group was significantly lower than SOX9 positive-expression group（24% vs 62%, χ^2=4.059, P =0.041）. Conclusion SOX7 and SOX9 can be used as indexes for hierarchical diagnosis and prognosis of prostate cancer due to their negative-expression and positive-expression, respectively.