神经降压素在胆管细胞癌中的表达及对预后的影响

Expressions of neurotensin in cholangiocarcinoma and its influence on prognosis

目的研究神经降压素(NTS)在胆管细胞癌组织及癌旁组织中的表达情况,探讨其与胆管细胞癌患者病理特征的关系及对预后的预测意义。方法选取2010年6月至2018年12月在福建医科大学附属泉州第一医院肿瘤外科行手术治疗的50例胆管细胞癌患者,获取其癌组织及癌旁组织,免疫组织化学检测NTS的表达水平,Real-time PCR检测NTS mRNA水平,Western-blotting检测NTS蛋白水平,分析胆管细胞癌患者病理特征与NTS表达水平的关系,用Cox回归模型分析胆管细胞癌患者预后的影响因素,ROC曲线分析NTS对胆管细胞癌预后的诊断效能。结果NTS表达于胆管细胞癌的细胞膜和细胞浆,细胞核未见表达,8%(4/50)肿瘤组织呈低度表达,38%(19/50)呈中等程度表达,54%(27/50)呈强阳性表达;胆管细胞癌组织中的NTS mRNA表达水平明显高于癌旁组织(0.859±0.159 vs.0.506±0.131),差异有统计学意义(χ^2=11.832,P<0.001);癌组织中NTS蛋白表达水平也明显高于癌旁组织(0.289±0.092 vs.0.133±0.038),差异有统计学意义(χ^2=10.859,P<0.001)。不同TNM分期、肿瘤直径、肿瘤数目、淋巴结转移状况患者的NTS表达水平差异有统计学意义(P<0.05)。Cox回归分析显示,NTS高表达为胆管细胞癌患者预后的独立危险因素。NTS判断预后的界值为41.8%,其灵敏度为0.69,特异度为0.88。结论NTS可能参与胆管细胞癌发展的进程,其高表达提示胆管细胞癌患者预后不良。

Objective This study to investigate the expression of neuroten sin(NTS)in cholangiocarcinoma and adjacent tissues,and to explore its relationship with clinicopathological parameters of cholangiocarcinoma and its clinical significance in the prognosis of cholangiocarcinoma.Methods Fifty patients with cholangiocarcinoma who underwent surgical treatment from June 2010 to December 2018 in the Oncological Surgery Department of Quanzhou First Hospital Affiliated to Fujian Medical University were selected.The expression level of NTS was detected by immunohistochemistry.The mRNA level of NTS was detected by real-time PCR.And the protein level of NTS was detected by Western-blotting.The expression difference of NTS in patients with different pathological features of characteristic in cholangiocarcinoma was analyzed.Cox regression model was used to analyze the influencing factors of prognosis of patients with cholangiocarcinoma.ROC curve was used to analyze the diagnostic efficiency of NTS for cholangiocarcinoma.Results NTS was expressed in the cell membrane and cytoplasm of cholangiocarcinoma,but not in the nucleus.8%(4/50)of tumor tissues showed low expression,38%(19/50)showed moderate expression,and 54%(27/50)showed strong positive expression.The expression level of NTS mRNA in cholangiocarcinoma tissues was significantly higher than that in adjacent tissues(0.859±0.159 vs.0.506±0.131),the difference was statistically significant(χ^2=11.832,P<0.001).Similarly,NTS protein levels in cholangiocarcinoma tissues were significantly higher than those in adjacent tissues(0.289±0.092 vs.0.133±0.038),the difference was statistically significant(χ^2=10.859,P<0.001).There were significant differences in NTS expression levels among patients with different TNM stages,tumor diameter,tumor number and lymph node metastasis(P<0.05).NTS was an independent risk factor for prognosis of patients with cholangiocarcinoma.The cutoff value of NTS for prognosis was 41.8%,with a sensitivity of 0.69 and a specificity of 0.88.Conclusions NTS may be involved in the development of cholangiocarcinoma,and its high expression suggests a poor prognosis in patients with cholangiocarcinoma.