宫颈鳞癌中神经丝蛋白轻链蛋白的表达及临床意义

Expression of Neurofilament Light Polypeptide in Cervical Squamous Cell Carcinoma and Clinical Significance

目的探讨神经丝蛋白轻链蛋白(NEFL)在宫颈鳞癌中的表达及其与临床病理因素和预后的关系。方法回顾性分析武汉市中心医院2009年12月至2015年5月收治入院并行手术治疗的58例宫颈鳞癌患者,收集其临床病理资料并行随访。采用免疫组化法检测宫颈鳞癌及癌旁组织中NEFL的表达情况,t检验或卡方检验分析NEFL表达与临床病理因素的关系,Kaplan-Meier生存函数分析计算累计复发及总生存时间,Log-rank检验比较生存曲线间的差异,单因素分析影响累计复发率和总生存率的因素,Cox比例风险模型分析影响预后的相关危险因素。结果宫颈癌肿瘤组织中NEFL的表达低于癌旁组织[(5.845±2.553)vs.(8.741±3.041),P<0.01],且NEFL低表达与FIGO分期(P=0.036)、淋巴结转移(P=0.006)、肿瘤浸润深度(P=0.034)相关。NEFL低表达组3年总生存率低于高表达组(36.66%vs.78.57%,P=0.023),术后3年累计复发率高于高表达组(61.33%vs.17.86%,P=0.018)。单因素分析示肿瘤FIGO分期、浸润深度、淋巴结转移及NEFL染色为总体生存率和累计复发率的影响因素(均P<0.05),多因素分析示FIGO分期Ⅲ/Ⅳ及NEFL低表达为影响总生存率及累计复发率的独立危险因子(均P<0.05)。结论宫颈鳞癌中NEFL的表达低于癌旁组织,NEFL低表达与FIGO分期、淋巴结转移、肿瘤浸润深度有关。NEFL低表达为影响宫颈磷癌总生存率及累计复发率的独立影响因素。

Objective To investigate the expression of neurofilament light polypeptide(NEFL)in cervical squamous cell carcinoma and its relationship with clinicopathological features and prognosis.Methods Clinicopathological data of 58 patients with cervical squamous cell carcinoma who were treated surgically between December 2009 and May 2015 in our hospital were retrospectively analyzed.Immunohistochemistry was performed to determine the expression of NEFL in tumor and paratumor tissues.The relationship between NEFL expression and clinicopathologic features was analyzed by t test orχ2 test.KaplanMeier method was used to analyze the overall survival and cumulative recurrence time,Log-rank test to compare the difference between survival curves,univariate analysis to measure the factors that affected the overall survival rate and cumulative recurrence rate and Cox’s proportional hazards regression model to analyze the related risk factors for prognosis.Results The expression of NEFL protein was much lower in tumor tissues than in adjacent normal tissues[(5.845±2.553)vs.(8.741±3.041),P<0.01]and a low expression of NEFL was significantly correlated with FIGO-stage(P=0.036),lymph node metastasis(P=0.006),and depth of infiltration(P=0.034).Patients with low expression of NEFL had a significantly lower 3-year overall survival rate(36.66%vs.78.57%,P=0.023)and higher cumulative recurrence rate(61.33%vs.17.86%,P=0.018)than those with high expression of NEFL.Univariate analysis showed that the FIGO-stage,depth of infiltration,lymph node metastasis and NEFL stains were factors that influenced the overall survival rate and the cumulative recurrence rate.By multivariate analysis,FIGO-stageⅢ/Ⅳand downexpression of NEFL were found to be independent prognosis factors for the overall survival rate and the cumulative recurrence rate(P<0.05).Conclusion The NEFL expression was lower in tumor tissues than in paratumor tissues.Lower expression of NEFL was closely related to FIGO stages,lymph node metastasis and depth of infiltration.It was an independent prognostic factor for cervical squamous cell cancer.