尾型同源盒转录因子2和同源框蛋白A9在膀胱癌组织中的表达及临床意义

Expressions of CDX2 and HOXA9 in bladder cancer and their relationships with prognosis

目的:探讨尾型同源盒转录因子2(CDX2)和同源框蛋白A9(HOXA9)蛋白在膀胱癌组织中的表达及与膀胱癌发生发展、预后的关系。方法:选取76例行膀胱癌根治术治疗患者的膀胱癌组织及相应癌旁组织标本(≥4 cm),另取同期因良性前列腺增生切除的83例正常膀胱黏膜组织标本。采用免疫组织化学法(SP法)检测CDX2和HOXA9蛋白表达,分析两者表达与膀胱癌患者临床特征、3年总生存率(OS)关系,采用COX分析影响膀胱癌患者预后的危险因子。结果:膀胱癌组织CDX2和HOXA9蛋白阳性率显著高于癌旁组织和正常膀胱黏膜组织(P<0.05),癌旁组织CDX2和HOXA9蛋白阳性率与正常膀胱黏膜组织比较差异无统计学意义(P>0.05)。CDX2、HOXA9蛋白表达与膀胱癌患者年龄、性别无关(P>0.05),与病理分期、分化程度及淋巴结转移有关(P<0.05)。膀胱癌患者CDX2蛋白表达与HOXA9蛋白表达呈正相关(r=0.401,P<0.05)。CDX2、HOXA9蛋白低表达膀胱癌患者OS明显高于高表达患者(P<0.05)。病理分期、分化程度、淋巴结转移、CDX2及HOXA9蛋白表达是影响膀胱癌患者预后的独立危险因素(P<0.05)。结论:膀胱癌患者CDX2、HOXA9蛋白表达均上调,与临床特征及预后关系密切,可为临床治疗提供新思路。

Objective: To analyze the expressions of CDX2 and HOXA9 in bladder cancer, and to explore their relationships with the occurrence, development and prognosis of bladder cancer. Methods: The bladder cancer tissues and corresponding para cancerous tissue specimens(≥4 cm) from 76 patients underwent radical resection of bladder cancer were selected, and 83 normal bladder mucosa tissues from benign prostatic hyperplasia patients who underwent radical resection of bladder cancer at the same time were collected. Immunohistochemical method(SP) was used to detect the expressions of CDX2 and HOXA9 proteins, the relationships between the two expressions with clinical characteristics and 3-year overall survival rate(OS) of bladder cancer patients were analyzed, COX analysis was used to analyze the risk factors affecting the prognosis of bladder cancer patients. Results: The positive rates of CDX2 and HOXA9 proteins in bladder cancer tissues were significantly higher than those in adjacent tissues and normal bladder mucosa tissues(P<0.05), the positive rates of CDX2 and HOXA9 proteins in adjacent tissues were higher than those in normal bladder mucosa tissues, but there was no significant difference between them(P>0.05). The expressions of CDX2 and HOXA9 were not related to the age and sex of patients with bladder cancer(P>0.05), were related to pathological stage, differentiation degree and lymph node metastasis(P<0.05). The expression of CDX2 protein was positively correlated with HOXA9 protein expression in bladder cancer patients(r=0.401,P<0.05). OS in patients with low expressions of CDX2 and HOXA9 proteins in bladder cancer was significantly higher than that in patients with high expressions(P<0.05). Pathological stage, degree of differentiation, lymph node metastasis, CDX2 and HOXA9 protein expression were independent risk factors for prognosis of bladder cancer patients(P<0.05). Conclusion: The expressions of CDX2 and HOXA9 proteins in bladder cancer patients are up-regulated, it is closely related to clinical characteristics and prognosis, so as to provide new ideas for clinical treatment.