单羧酸转运蛋白4在胰腺癌中的表达及临床预后价值

Expression of monocarboxylate transporter 4 in pancreatic cancer and its prognostic value

目的:分析单羧酸转运蛋白4(monocarboxylate transporter 4,MCT4)在胰腺癌组织中的表达及其在胰腺癌根治性手术后的预后预测价值。方法:回顾性分析2010年2月至2014年6月在复旦大学附属肿瘤医院胰腺外科接受根治性手术切除的379例胰腺癌患者的临床资料。运用免疫组化染色检测MCT4在胰腺癌组织中的表达,分析其与患者临床病理特征的关系。采用Kaplan-Meier生存曲线和多因素Cox回归分析模型分析MCT4对患者预后的预测价值。结果:胰腺癌组织中MCT4阳性表达患者的肿瘤最大径更大(P=0.004),更容易出现淋巴结转移(P=0.005),TNM分期也更高(P=0.011)。MCT4阳性表达患者的中位总生存(overall survival,OS;12.4个月)和无复发生存(recurrence-free survival,RFS;7.3个月)时间均显著短于MCT4阴性表达患者(21.3个月,P<0.001;11.4个月,P<0.001)。多因素Cox回归分析显示,胰腺癌组织中MCT4阳性表达是胰腺癌患者术后OS时间(风险比=1.814,95%置信区间1.433~2.296,P<0.001)和RFS时间(风险比=1.648,95%置信区间1.319~2.059,P<0.001)短的独立预测因子。结论:胰腺癌组织MCT4阳性表达是胰腺癌患者术后预后不良的独立预测因子,可作为筛选胰腺癌术后高危人群的重要指标以及潜在的治疗靶点。

Objective:To determine the expression of monocarboxylate transporter 4(MCT4)in pancreatic cancer tissue and its prognostic value after radical resection.Methods:The clinical data of 379 pancreatic cancer patients who underwent radical resection at Pancreatic Surgery of Fudan University Shanghai Cancer Center from February 2010 to June 2014 were retrospectively included in the study.The expression of MCT4 was tested with immunohistochemical staining and its relationship with clinicopathological characteristics of patients was investigated.Kaplan-Meier survival curve and multivariate Cox regression analysis were applied to evaluate the prognostic value of MCT4 expression.Results:Patients with positive expression of MCT4 protein were prone to have larger tumor size(P=0.004),greater lymph node metastasis(P=0.005),and higher TNM stage(P=0.011).The median overall survival(OS,12.4 months)time and recurrence-free survival(RFS,7.3 months)time of patients with positive expression of MCT4 were significantly shorter than those of patients with negative expression of MCT4(21.3 months,P<0.001;11.4 months,P<0.001).Multivariate Cox regression analysis results showed that the positive expression of MCT4 was an independent predictor of shorter OS(hazard ratio=1.814,95%confidence interval 1.433-2.296,P<0.001)and RFS(hazard ratio=1.648,95%confidence interval 1.319-2.059,P<0.001)in pancreatic cancer patients after radical resection.Conclusions:The positive expression of MCT4 is an independent prognostic factor for pancreatic cancer patients after radical resection,and might be a potential marker for the selection and treatment of patients with high recurrence risk.