人催乳素受体蛋白在肛周脓肿患者中的表达及其与预后的关系

Association of prolactin receptor experssion in human perianal abscess with postoperative prognosis

目的探讨人催乳素受体蛋白在肛周脓肿组织中的表达及其与临床病理特征的关系,预测可能作为肛周脓肿预后的一个生物标志物。方法收集2015年08月至2016年08月杭州市第三人民医院肛肠外科收治的肛周脓肿行手术切排并经病理证实的60例患者的肛管黏膜组织标本(肛周脓肿组)及临床资料。另取年龄、性别、体重相匹配的8例单纯痔病患者的肛管黏膜组织标本作为对照(对照组)。运用免疫组织化学(免疫组化)和Western blot方法检测两组标本中催乳素受体蛋白表达水平,并结合临床病理资料进行统计分析。同时采用单因素及多因素Logistic回归分析探讨组织中PRLR表达水平与肛周脓肿预后的相关性。结果免疫组化结果显示,PRLR蛋白阳性的棕色颗粒主要弥漫性分布在细胞膜中,部分可见于细胞质。其中在脓肿组肛管黏膜中低表达率为68.33%(41/60)及高表达率31.67%(19/60),与对照痔病组PRLR蛋白高表达相比,差异具有统计学意义(χ~2=5.701,P<0.05);同时Western Blot结果显示PRLR蛋白在脓肿组中的表达灰度比值(0.515±0.067)明显低于对照组灰度比值(0.836±0.035)(t=3.14,P<0.01);全组患者未愈为34例,占56.67%。其中PRLR低表达与高表达,分别为79.41%(27/41)和20.59%(7/19)。单因素及多因素分析显示,脓肿性质(OR=7.911,95%CI:1.115~20.161,P=0.039)、脓肿切口(OR=3.246,95%CI:0.774~5.742,P=0.042)及PRLR低表达量(OR=9.099,95%CI:1.727~14.426,P=0.016)是肛周脓肿患者预后不良的独立危险因素(均P<0.05)。结论 PRLR蛋白在肛周脓肿患者肛管黏膜组织中表达显著降低,同时低表达的PRLR对判断手术后肛周脓肿患者预后具有较好的参考价值。

Objective To investigate the association of prolactin receptor(PRLR)expression in human perianal abscess with its prognosis,which may be a new prognosis biomarker of perianal abscess-related.Methods Clinical data and resection samples of60patients with perianal abscess identified by pathology undergoing resection in our department from August2015to August2016were collected as well as8patients receiving only hemorroidectomy(control group),matching with perianal abscess group in age,gender and body weight.The PRLR expression in perianal abscess tissues and matched nonabscess tissues collected was detected by immunohistochemical staining and Western blotting.The associations of PRLR level with overall prognosis,clinicopathological features were analyzed,univariate and multivariate logistic regression analysis.Results Immunohistochemical staining showed that the positive brown granules were mainly distributed on the cell membrane,and also in cytoplasm partially.And the low expression of PRLR protein in perianal abscess group was81.67%(41/60)and high espression wsa31.67%(19/60),which was significantly higher than that of control group(P<0.05).The relative gray value of Western blotting in perianal abscess tissues were0.515±0.067,which were significantly lower than those of matched nonabscess tissues(0.836±0.035and P<0.05).Patients with low expression of PRLR protein had poor prognosis than those with low expression(68.85%vs.36.84%,P<0.05).Univariate and Multivariate logistic regression analysis showed that the complexity of abscess(OR=7.911,95%CI:1.115~20.161,P=0.039),the number of surgical incision(OR=3.246,95%CI:0.774~5.742,P=0.042)and the expression of PRLR protein(OR=9.099,95%CI:1.727~14.426,P=0.016)were independent risk factors for poor prognosis of patients with perianalabscess(all P<0.05).Conclusions PRLP expression in perianal abscess patient was low,which may be a valuable in predicting prognosis.