JAG1蛋白表达水平对结直肠癌患者切除术后预后影响的临床研究

Effect of JAG1 protein expression on prognosis of patients with colorectal cancer after resection

目的:探讨JAG1蛋白表达水平对结直肠癌患者切除术后预后的影响。方法:选择2008年1月—2013年12月接受手术切除的结直肠癌患者48例,另选择同期48例结直肠良性疾病患者作为对照。检测结直肠癌组织、癌旁组织、结直肠良性组织中JAG1 mRNA和蛋白,测定结直肠癌患者术后血清JAG1水平、实验室检测指标及临床病理学参数,并比较它们之间的相关性,分析结直肠癌患者术后预后的危险因素。结果:结直肠良性组织JAG1蛋白阳性表达率为10.42%(5/48)、癌旁组织JAG1蛋白阳性表达率为45.83%(22/48),显著低于结直肠癌组织的83.33%(40/48)(P<0.05)。结直肠良性组织JAG1 mRNA和蛋白相对表达量水平为(0.35±0.08)、(0.12±0.04),癌旁组织JAG1 mRNA和蛋白相对表达量水平为(0.92±0.38)、(0.52±0.16),显著低于直肠癌组织的(1.98±0.43)(1.67±0.54)(P<0.05)。结直肠癌患者血清JAG1水平为(198.14±35.67)pg/mL,显著高于对照组中的(94.37±25.43)pg/mL(P<0.05)。JAG1与CA125、CEA、CRP呈正相关(P<0.05),与浸润深度、淋巴结转移、TNM分期、肿瘤分化程度呈正相关(P<0.05)。Logistic回归分析结果显示,浸润深度、淋巴结转移、TNM分期、分化程度、血清JAG1高表达是影响结直肠癌患者RFS的危险性因素(P<0.05);浸润深度、淋巴结转移、TNM分期、血清JAG1高表达是影响结直肠癌患者OS的危险性因素(P<0.05)。结论:JAG1蛋白可以作为诊断结直肠癌切除术后影响预后的特异性指标,也可成为结直肠癌癌基因治疗的新靶点。血清JAG1水平偏高不利于结直肠癌患者术后预后。

Objective： To investigate the effect of JAG1 protein expression on the prognosis ofpatients with colorectal cancer. Methods： 48 patients with colorectal cancer in our hospital from Jan 2008 to Dec 2013 were selected. Another 48 patients with colorectal benign diseases who were treated in our hospital during the same period were selected as control. JAG1 mRNA and protein in colorectal cancer tissues, paracancerous tissues and benign colorectal tissue, determination of post- operative patients with colorectal cancer detection index of serum JAG1 level, laboratory and clinical pathological parameters, and compared the correlation between them. Analysis of risk factors for postoperative prognosis of colorectal cancer patients using unconditional Logistic regression analy- sis. Results： The positive expression rate of JAG1 protein in colorectal benign tissues was 10.42% （5/48）, and the positive rate of JAG1 protein in paracancerous tissues was 45.83%（22/48）, which was significantly lower than that in colorectal cancer tissue （83.33%）（40/48）（P〈0.05）. JAG1 mRNA and protein in colorectal benign tissue relative expression level were （0.35 ± 0.08）, （0.12 ± 0.04）, JAG1 mRNA and protein in paracancerous tissue relative expression level were（0.92 ± 0.38）, （0.52 ± 0.16）, significantly lower than that of rectal carcinoma （1.98 ±0.43） （1.67±0.54） （P〈0.05）. The serum JAG1 level of colorectal cancer patients was significantly higher than that in control group（P〈0.05）. The serum JAG1 level of colorectal cancer patients was positively correlated with CA125, CEA, CRP, invasion depth, lymph node metastasis, TNM stage, tumor differentiation degree（P〈0.05）. Multivari- ate Cox proportional hazard regression model analysis showed that the depth of invasion, lymph node metastasis, TNM staging, differentiation degree, high serum JAG1 expression were risk factors of RFS patients with colorectal cancer （P〈0.05）; The depth of invasion, lymph node metastasis, TNM staging, high serum JAG1 expression were risk factors of OS patients with colorectal cancer（P〈0. 05）. Concluson： JAG1 protein can be used as a specific marker for the prognosis of colorectal cancer after resection, and may also be a new target for gene therapy of colorectal cancer. High serum JAG1 level is not conducive to the prognosis of patients with colorectal cancer.