CXC趋化因子受体6与肾透明细胞癌预后的相关性分析

Correlation analysis between CXC chemokine receptor 6 and prognosis of renal clear cell carcinoma

目的探讨CXC趋化因子受体6(CXCR6)与肾透明细胞癌预后的相关性。方法选取2013年1月至2014年10月在四川省资阳市第一人民医院接收手术治疗的肾透明细胞癌患者100例,采用免疫组织化学法检测肾透明细胞癌组织及癌旁正常组织中CXCR6表达情况。观察肾透明细胞癌组织及癌旁正常组织中CXCR6表达阳性率,探讨肾透明细胞癌总生存(OS)及无进展生存(PFS)的影响因素。结果肾透明细胞癌组织CXCR6表达阳性率(46.0%,46/100)高于癌旁组织(20.0%,20/100),差异有统计学意义(χ2=15.287,P<0.01)。临床分期为Ⅲ~Ⅳ期、有淋巴结转移、病理分级为Ⅲ~Ⅳ级患者CXCR6阳性表达率分别高于临床分期Ⅰ~Ⅱ期、无淋巴结转移、病理分级Ⅰ~Ⅱ级患者,差异均有统计学意义(均P<0.05)。共92例患者完成随访,死亡40例。随访时间35~60个月,中位随访时间48.9个月。CXCR6表达阳性患者3年OS率、PFS率均低于表达阴性患者,差异有统计学意义(3年OS率:52.1%比78.6%,χ^2=10.027,P=0.001;3年PFS率:48.3%比67.8%,χ^2=4.344,P=0.037)。Cox回归多因素分析显示,病理分级(OS:OR=2.154,95%CI 1.547~9.517,P=0.023;PFS:OR=1.235,95%CI 1.109~5.917,P=0.042)、淋巴结转移(OS:OR=1.412,95%CI 1.109~5.917,P=0.041;PFS:OR=1.841,95%CI 1.354~8.994,P=0.010)、CXCR6表达(OS:OR=1.864,95%CI 1.358~6.813,P=0.031;PFS:OR=1.457,95%CI 1.127~6.884,P=0.025)是经手术治疗肾透明细胞癌OS及PFS的独立危险因素。结论CXCR6表达阳性是肾透明细胞癌OS和PFS的独立危险因素,CXCR6表达阳性患者预后较差。

Objective To investigate the correlation between CXC chemokine receptor 6(CXCR6)and prognosis of renal clear cell carcinoma.Methods A total of 100 patients with renal clear cell carcinoma who underwent surgery in the First People's Hospital of Ziyang from January 2013 to October 2014 were selected.Immunohistochemistry was used to detect the expression of CXCR6 in 100 cases of renal clear cell carcinoma and adjacent normal tissues.The patients were followed up to observe the positive rate of CXCR6 expression and the factors affecting overall survival(OS)and progression-free survival(PFS)of renal clear cell carcinoma and adjacent normal tissues.Results The positive rate of CXCR6 expression in renal clear cell carcinoma tissues was higher than that in adjacent tissues,and the difference was statistically significant[46.0%(46/100)vs.20.0%(20/100),χ^2=15.287,P<0.01].The positive expression rate of CXCR6 in patients with clinical stageⅢ-Ⅳ,lymph node metastasis and pathological gradeⅢ-Ⅳwas higher than that in patients with clinical stageⅠ-Ⅱ,pathological gradeⅠ-Ⅱand without lymph node metastasis,and the difference was statistically significant(all P<0.05).A total of 92 patients were followed up and 40 died.The follow-up time reached to(35-60)months and the median follow-up time was 48.9 months.Kaplan-Meier and log-rank test showed that patients with positive CXCR6 expression had lower 3-year OS and PFS rate compared with patients with negative CXCR6 expression,and the difference was statistically significant(3-year OS rate:52.1%vs.78.6%,χ^2=10.027,P=0.001;3-year PFS rate:48.3%vs.67.8%,χ2=4.344,P=0.037).Cox regression multivariate analysis showed pathological grade(OS:OR=2.154,95%CI 1.547-9.517,P=0.023;PFS:OR=1.235,95%CI 1.109-5.917,P=0.042),lymph node metastasis(OS:OR=1.412,95%CI 1.109-5.917,P=0.041;PFS:OR=1.841,95%CI 1.354-8.994,P=0.010),CXCR6 expression(OS:OR=1.864,95%CI 1.358-6.813,P=0.031;PFS:OR=1.457,95%CI 1.127-6.884,P=0.025)were independent risk factors of OS and PFS for renal clear cell carcinoma patients treated by the surgery.Conclusions The positive expression of CXCR6 is an independent risk factor for OS and PFS of renal clear cell carcinoma.The prognosis of patients with positive CXCR6 expression is poor.