外周血肿瘤异常蛋白在结直肠癌患者中的表达及预后价值研究

Expression and prognostic significance of tumor abnormal protein on peripheral blood in colorectal cancer patients

目的:研究肿瘤异常蛋白(tumor abnormal protein,TAP)在结直肠癌患者外周血中的表达及预后意义。方法:收集2014年6月至2016年12月确诊的237例结直肠癌患者为研究对象并进行随访,检测患者治疗前外周血中TAP表达情况,利用卡方检验分析TAP表达与结直肠癌患者临床特征的关系,收集患者外周血传统肿瘤标志物CEA和CA19-9的表达数据,分析外周血TAP表达与CEA和CA19-9的关系。利用Kaplan-Meier生存曲线、单因素及多因素Cox回归分析TAP表达与结直肠癌患者预后的关系。结果:237例结直肠癌患者外周血TAP阳性率为59.92%。不同分化程度、不同肌层浸润深度、有无淋巴结转移以及不同Dukes分期的结直肠癌患者之间,外周血TAP的表达差异具有统计学意义(P<0.05)。外周血TAP表达与CEA和CA19-9的表达无关(P>0.05)。TAP阳性表达组结直肠癌患者的总生存期低于阴性表达组,差异具有统计学意义(P<0.05)。多因素Cox回归分析校正了年龄、性别、分化程度、肌层浸润深度、淋巴结转移、Dukes分期、CEA表达和CA19-9表达等因素后,外周血TAP的表达与结直肠癌总生存期依然显著相关(HR=2.511,95%CI=1.494~4.221,P<0.05)。此外,外周血TAP对结直肠癌患者生存预后预测的风险比大于传统肿瘤标志物CEA和CA19-9。结论:结直肠癌患者外周血中TAP的表达与肿瘤的恶性程度相关,外周血中TAP的表达可以作为结直肠癌独立的预后指标,对患者的总生存期具有预测作用。

Objective:To investigate the expression and prognostic significance of tumor abnormal protein(TAP) on peripheral blood in colorectal cancer patients. Methods:A total of 237 colorectal cancer patients from June 2014 to December 2016 were enrolled and followed up. The pre-treatment TAP expression in peripheral blood was detected,the chi-square test was used to analyze the correlation between TAP expression and clinical features of colorectal cancer patients,the expression data of traditional tumor markers CEA and CA19-9 in peripheral blood of patients were collected,and the relationship among TAP expression,CEA and CA19-9 were analyzed. Kaplan-Meier survival curve and univariate and multivariate Cox regression were used to analyze the relationship between TAP expression and prognosis in colorectal cancer patients. Results:Among 237 colorectal cancer patients,59.92% patients had positive expression of TAP in peripheral blood. Peripheral blood TAP expression was associated with tumor cell differentiation,depth of myometrial invasion,lymph node metastasis,and tumor stage(Dukes stage),with statistically significant difference(P<0.05). After multivariate Cox regression’s correction of age,gender,cell differentiation,invasion degree,lymph node metastasis,Dukes stage,CEA expression and CA19-9 expression,TAP expression in the peripheral blood was significantly associated with overall survival time of colorectal cancer(HR=2.511,95%CI=1.494-4.221,P<0.05). In addition,the risk ratio of peripheral blood TAP for predicting survival outcome in colorectal cancer patients was higher than that of CEA and CA19-9. Conclusion:The expression of TAP in peripheral blood of colorectal cancer patients is related to the malignant degree of cancer,and can be used as an independent prognostic indicator for colorectal cancer,with predicating function for patients’ overall survival time.