宫颈癌组织CTNNB1和TP53表达特点及其临床意义研究

Study on the expression and clinical significance of CTNNB1 and TP53 in cervical cancer

目的研究宫颈癌组织钙黏蛋白相关蛋白(CTNNB1)、肿瘤抑制因子P53(TP53)表达特点及其临床意义。方法采用回顾性研究方法,选取2016年1月至2019年10月河北北方学院附属第二医院收治的124例宫颈癌患者(宫颈癌组)及124例宫颈良性疾病患者(良性组),比较不同组织中CTNNB1 mRNA、TP53 mRNA的表达情况及CTNNB1 mRNA、TP53 mRNA不同表达者的临床病理特征,采用Spearman分析CTNNB1 mRNA、TP53 mRNA与临床病理特征的相关性,采用受试者操作特征曲线(ROC)及ROC下面积(AUC)分析CTNNB1 mRNA、TP53 mRNA预测复发的价值。结果宫颈良性病变组织、癌旁组织、宫颈癌组织CTNNB1 mRNA表达分别为0.18±0.05、0.56±0.14、3.89±1.23,依次升高,TP53 mRNA表达分别为0.67±0.22、0.15±0.04、0.09±0.02,依次降低,组间比较差异均具有统计学意义(P<0.05);CTNNB1 mRNA、TP53 mRNA高低表达者国际妇产科联盟(FIGO)分期、分化程度、淋巴结转移比较,差异均具有统计学意义(P<0.05);CTNNB1 mRNA与FIGO分期(r=0.596)、腹主动脉旁淋巴结转移(r=0.648)、盆腔淋巴结转移(r=0.727)呈正相关,与分化程度(r=-0.312)呈负相关(P<0.05);TP53 mRNA与FIGO分期(r=-0.732)、腹主动脉旁淋巴结转移(r=-0.841)、盆腔淋巴结转移(r=-0.675)呈负相关,与分化程度(r=0.516)呈正相关(P<0.05);复发患者CTNNB1 mRNA为5.93±1.81,高于未复发患者的3.12±1.01,TP53 mRNA为0.10±0.02,低于未复发患者的0.06±0.02,差异有统计学意义(P<0.05);CTNNB1 mRNA预测复发的AUC为0.715,TP53mRNA预测复发的AUC为0.773,CTNNB1 mRNA+TP53 mRNA预测复发的AUC为0.881,差异有统计学意义(P<0.05)。结论宫颈癌组织中CTNNB1呈高表达,TP53呈低表达,与组织分化程度、淋巴结转移、肿瘤分期显著相关,并能预测宫颈癌术后复发的风险。

Objective To study the expression of cadherin-related protein(CTNNB1)and tumor suppressor p53(TP53)and their clinical significance in cervical cancer.Methods 124 patients with cervical cancer(cervical cancer group)and 124 patients with benign cervical disease(benign group)admitted to the Second Affiliated Hospital of Hebei North University from January 2016 to October 2019 were selected and retrospectively analyzed.The expression of CTNNB1 mRNA,TP53 mRNA and the clinicopathological characteristics of CTNNB1 mRNA and TP53 mRNA in different tissues were compared,Spearman was used to analyze the correlation between CTNNB1 mRNA,TP53 mRNA and clinicopathological features,receiver operator characteristic curve(ROC)curve and area under the curve(AUC)were used to analyze the value of CTNNB1 mRNA and TP53 mRNA in predicting recurrence.Results The expressions of CTNNB1 mRNA in benign cervical lesions,paracancerous tissues,and cervical cancer tissues were(0.18±0.05),(0.56±0.14),and(3.89±1.23),which increased in order.The expressions of TP53 mRNA were(0.67±0.22),(0.15±0.04),and(0.09±0.02),which decreased in order,the differences between the groups were statistically significant(P<0.05).The stages of the International Federation of Obstetrics and Gynecology(FIGO),degree of differentiation,and lymph node metastasis had significant difference in high and low expression of CTNNB1 mRNA and TP53 mRNA(P<0.05).CTNNB1 mRNA was positively correlated with FIGO stage(r=0.596),para-aortic lymph node metastasis(r=0.648),pelvic lymph node metastasis(r=0.727),and negatively correlated with degree of differentiation(r=-0.312)(P<0.05);TP53 mRNA was negatively correlated with FIGO stage(r=-0.732),para-aortic lymph node metastasis(r=-0.841),pelvic lymph node metastasis(r=-0.675),and positively correlated with the degree of differentiation(r=0.516)(P<0.05);CTNNB1 mRNA in relapsed patients was(5.93±1.81),which was higher than that in non-relapsed patients(3.12±1.01),and TP53 mRNA was(0.10±0.02),which was lower than that in non-relapsed patients(0.06±0.02)(P<0.05);the AUC of CTNNB1 mRNA predicting relapse was 0.715,the AUC of TP53 mRNA predicting recurrence was 0.773,and the AUC of CTNNB1 mRNA+TP53 mRNA predicting recurrence was 0.881(P<0.05).Conclusion The expression of CTNNB1 is high and TP53 is low in cervical cancer,it is significantly related to the degree of tissue differentiation,lymph node metastasis,and tumor staging,and can predict the risk of cervical cancer recurrence after surgery.