胃癌患者肌肉组织中泛素表达与营养状况和预后的关系

Correlation of ubiquitin expression in muscles of gastric cancer patients with their nutritional status and prognosis

目的 研究胃癌患者肌肉组织中泛素（Ub）表达与患者营养状况和预后的关系.方法 采用逆转录PCR、Western blot检测102例胃癌和53例腹腔良性疾病患者腹直肌中Ub mRNA和蛋白的表达.结果 胃癌患者腹直肌中Ub mRNA表达较腹腔良性疾病患者明显升高（4.10±1.04比3.17±0.32,t=7.386,P=0.000）;胃癌患者腹直肌中Ub蛋白表达较腹腔良性疾病患者明显升高（0.151±0.058比0.084±0.046,t=7.275,P=0.000）;胃癌患者腹直肌中Ub mRNA表达升高与患者体质量丢失、体质量指数、营养预后指数、血清白蛋白及血红蛋白水平的下降有关（x2分别为11.780、6.557、11.849、15.742、8.360,P分别为0.001、0.010、0.001、0.000、0.004）;胃癌患者腹直肌中UbmRNA表达升高与患者的性别、年龄、肿瘤大小和Borrmann分型无关（x2分别为0.038、1.978、0.486、1.483,P分别为0.774、0.160、0.486、0.223）,而与胃癌病理类型、淋巴结转移及TNM分期有关（x2分别为11.260、9.362、20.517,P分别为0.004、0.002、0.000）.胃癌患者腹直肌中UbmRNA的表达水平与患者的生存率有关（x2=5.775,P=0.016）.结论 胃癌患者腹直肌中Ub mRNA和蛋白表达较非肿瘤患者明显升高,且Ub mRNA表达升高与患者的营养状况和预后有关,Ub可能在癌性恶液质的发展过程中起重要作用.

Objective To look into the effect of ubiquitin （Ub） in muscles of gastric cancer patients on their nutritional status and prognosis.Methods Abdominal rectus muscles of 102 patients with gastric cancer and 53 patients with benign abdominal diseases were studied.The expressions of Ub mRNA and protein were assessed through real time-PCR and Western blot.Results The relative expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients （4.10± 1.04） was significantly upregulated compared with the control group （3.17±0.32） （t =7.386,P=0.000）.The expression of Ub protein in rectus abdominis muscles of patients with gastric cancer was upregulated compared with the controls （0.151 ±0.058 vs.0.084±0.046,t =7.275,P =0.000）.The high expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients was significantly associated with decreases in weight,body mass index,prognostic nutritional index,serum albumin and hemoglobin （x2 =11.780,6.557,11.849,15.742,8.360;P=0.001,0.010,0.001,0.000,0.004）.The high expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients was not correlated with the patients＇sex,age,tumor size or Borrmann type （x2 =0.038,1.978,0.486,1.483;P=0.774,0.160,0.486,0.223）,but it was related to the pathologic type,lymph node metastasis and TNM staging of gastric carcinoma （x2 =11.260,9.362,20.517;P=0.004,0.002,0.000）.The survival rate of gastric cancer patients with high expression of Ub mRNA was lower than those with low expression （x2 =5.775,P =0.016）.Conclusions Ub mRNA and protein were upregulated in rectus abdominis muscles of gastric cancer patients.The high expression of Ub mRNA in these patients was related to their nutritional status and prognosis,which might play an important role in the development of cachexia.