CBX4和NET-1在原发性直肠癌中的表达变化及临床意义

Expression and clinical significance of CBX4 and NET-1 in rectal cancer

目的探究染色盒同源物4(CBX4)和新四极体-1(NET-1)在原发性直肠癌中的表达变化及临床意义,并对二者致癌作用的相关性进行分析。方法选取唐山市协和医院2013年4月至2015年7月收治的50例原发性直肠癌患者为研究对象,收集其癌组织及癌旁正常直肠组织,采用免疫组织化学法检测CBX4和NET-1在组织中的表达水平,并分析CBX4和NET-1阳性表达与患者临床病理特征的关系。采用Spearman分析二者在原发性直肠癌组织中表达水平的相关性;采用Kaplan-Meier分析二者表达情况与原发性直肠癌患者生存率的关系;采用多因素Logistic回归分析影响患者预后的危险因素。结果原发性直肠癌患者癌组织中CBX4和NET-1阳性表达率分别为74.00%、68.00%,明显高于癌旁正常组织的28.00%、24.00%,差异均有统计学意义(P<0.05)。原发性直肠癌组织中的CBX4和NET-1表达水平在不同性别、年龄、吸烟、饮酒及肿瘤最大径的患者之间比较,差异均无统计学意义(P>0.05),而在不同TNM分期、有无淋巴结转移、不同分化程度、有无浆膜浸润患者之间比较,差异均有统计学意义(P<0.05)。CBX4和NET-1在原发性直肠癌组织中的表达水平呈正相关(r=0.647,P<0.05)。术后随访发现患者5年总生存率为32.00%(16/50),CBX4和NET-1高表达患者5年生存率分别为21.62%(8/37)、17.65%(6/34),明显低于CBX4和NET-1低表达患者5年生存率61.54%(8/13)、62.50%(10/16),差异均有统计学意义(P<0.05)。Logistic回归分析表明,TNM分期(Ⅲ~Ⅳ期)、淋巴结转移及CBX4、NET-1表达水平都是影响原发性直肠癌患者预后的独立危险因素(P<0.05)。结论CBX4和NET-1在原发性直肠癌组织中阳性表达率明显升高,与患者TMN分期、淋巴结转移、分化程度、浆膜浸润相关,且二者在直肠癌组织中的表达水平呈正相关,可能成为评价原发性直肠癌患者预后的临床指标。

Objective To investigate the expression changes and clinical significance of chromobox homolog 4(CBX4)and new EST tetraspan numbered-1(NET-1)in primary rectal cancer,and analyze the correlation between their carcinogenic effects.Methods From April 2013 to July 2015,a total of 50 patients with primary rectal cancer in Tangshan Union Hospital were selected as the study objects,and their cancer tissues and normal rectal tissues beside the cancer were collected,the expression levels of CBX4 and NET-1 were detected by immunohistochemistry,the relationships between the positive expressions of CBX4,NET-1 and the clinicopathological characteristics of the patients were analyzed.Spearman was used to analyze the correlation between the expression level of the two in rectal cancer.Kaplan-Meier was used to analyze the relationships between their expressions and survival rate of patients with primary rectal cancer.Multivariate Logistic regression was used to analyze the risk factors affecting the prognosis of patients.Results The positive expression rates of CBX4 and NET-1 were 74.00%and 68.00%,respectively,which were significantly higher than 28.00%and 24.00%of the adjacent tissues(P<0.05).The differences on expression levels of CBX4 and NET-1 in primary rectal cancer were not statistically significant in patients with different gender,age,smoking,drinking and tumor diameter(P>0.05),but were statistically significant in patients with different TNM stage,lymph node metastasis,differentiation degree and serous infiltration(P<0.05).There was a positive correlation between CBX4 and NET-1 in primary rectal cancer tissues(r=0.647,P<0.05).The 5-year overall survival rate of all patients was 32.00%(16/50),the 5-year survival rates of patients with high expression of CBX4 and NET-1 were 21.62%(8/37)and 17.65%(6/34),which were significantly lower than those of patients with low expression of CBX4 and NET-1,and their 5-year survival rates were 61.54%(8/13)and 62.50%(10/16)respectively(P<0.05).Logistic regression analysis showed that TNM stage(Ⅲ-Ⅳstage),lymph node metastasis and high expressions of CBX4 and NET-1 were independent risk factors for prognosis of primary rectal cancer patients(P<0.05).Conclusion The positive expression rates of CBX4 and NET-1 in primary rectal cancer are significantly increased,which are related to TMN stage,lymph node metastasis,differentiation degree and serous infiltration,and the expression levels of CBX4 and NET-1 in rectal cancer tissue are positively correlated,which may become clinical indexes to evaluate the prognosis of rectal cancer patients.