KIF4A蛋白在胰腺癌组织中的表达及临床意义

Expression and clinical significance of KIF4A protein in pancreatic cancer

目的:探讨驱动蛋白家族4A(kinesin family member 4A,KIF4A)蛋白在胰腺癌组织中的表达情况及临床意义。方法:选择东南大学附属中大医院手术切除并经病理证实的72例胰腺癌患者的癌组织及癌旁组织标本。采用免疫组织化学法检测KIF4A蛋白表达情况;比较KIF4A在胰腺癌组织中的表达与患者临床参数的关系;采用Kaplan-Meier法分析KIF4A在胰腺癌中的表达与患者预后的关系;采用Cox比例风险模型进行胰腺癌预后的多因素分析。结果:KIF4A阳性细胞主要表达在细胞核内,与癌旁组织相比,KIF4A在胰腺癌组织中的阳性表达率显著升高(χ2=32.211,P<0.05)。肿瘤TNM分期Ⅲ期患者胰腺癌组织中KIF4A阳性表达率高于Ⅰ+Ⅱ者,分化程度低的患者KIF4A阳性表达率高于分化程度高+中者,有淋巴结转移的患者KIF4A阳性表达率高于无淋巴结转移者(P<0.05)。生存分析结果显示胰腺癌组织中KIF4A阳性表达组生存时间明显低于KIF4A阴性表达组(χ2=10.306,P=0.001)。Cox比例风险回归模型结果显示:TNM分期(P=0.011)、肿瘤分化程度(P<0.001)、淋巴结转移(P=0.001)、KIF4A阳性表达(P=0.043)是胰腺癌患者预后的独立危险因素。结论:KIF4A在胰腺癌组织中呈阳性表达,且与TNM分期、分化程度、淋巴结转移及不良预后有关,KIF4A可作为胰腺癌患者预后的分子标志物。

Objective: To investigate the expression of kinesin family member 4A(KIF4A) protein in pancreatic cancer and its clinical significance. Methods: The specimens of pancreatic cancer and its adjacent tissues were selected from 72 patients who were surgically removed and confirmed by pathology. The expression level of KIF4A protein in each group was detected by immunohistochemistry. The expression of KIF4A in pancreatic cancer and its relationship with clinical parameters were compared between the two groups. Kaplan-Meier method was used to analyze the relationship between the expression of KIF4A and the prognosis of patients. Cox proportional risk model was used to for multivariate analysis of pancreatic cancer prognosis. Results: KIF4A positive cells were mainly expressed in the nucleus, and the positive expression rate of KIF4A in pancreatic cancer was significantly higher than that in adjacent tissues(χ2=32.211, P<0.05). The positive expression rate of KIF4A in patients with TNM stage Ⅲ was higher than that in patients with stage Ⅰ+Ⅱ. The positive expression rate of KIF4A in patients with low differentiation was higher than that in patients with high and medium differentiation. The positive expression rate of KIF4A in patients with lymph node metastasis was higher than that in patients without lymph node metastasis(P<0.05). Survival analysis showed that the survival time of KIF4A positive expression group was significantly lower than that of KIF4A negative expression group(χ2=10.306, P=0.001). The Cox proportional hazard regression model was used to analyze the risk factors for the prognosis of pancreatic cancer. The results showed that TNM stage(P=0.011), and the tumor differentiation(P<0.001), lymph node metastasis(P=0.001), expression level of KIF4A positive expression(P=0.043) were independent risk factors for prognosis of pancreatic cancer patients. Conclusion: KIF4A is positively expressed in pancreatic cancer and is related to TNM stage, differentiation degree, lymph node metastasis, and poor prognosis. KIF4A can be used as a molecular marker for prognosis of pancreatic cancer.