FOXO3联合XPNPEP2和MMP-14对结直肠癌不良预后的预测分析

FOXO3,XPNPEP2 and MMP-14 for predicting poor prognosis of colorectal cancer

目的探讨叉头框蛋白O3(FOXO3)、氨肽酶P2(XPNPEP2)和基质金属蛋白酶-14(MMP-14)联合预测结直肠癌不良预后的临床价值。方法选取2018年1月至2019年12月间西安医学院第一附属医院收治的77例结直肠癌患者癌组织及癌旁正常组织。根据结直肠癌患者预后情况分为良好组(32例)与不良组(45例)。比较两组患者临床资料,分析导致患者不良预后的危险因素,通过受试者工作特征曲线(ROC)分析评估其预测价值。结果与正常组织相比,癌组织中FOXO3表达评分降低,XPNPEP2及MMP-14表达评分均升高,差异均有统计学意义(P<0.05)。经单因素分析,TNM分期、FOXO3低表达、XPNPEP2高表达及MMP-14高表达均是引起患者不良预后的单因素(均P<0.05)。经Logistic回归分析,FOXO3低表达、XPNPEP2高表达及MMP-14高表达是结直肠癌患者发生不良预后的独立危险因素(均P<0.05)。经ROC曲线分析得到,FOXO3、XPNPEP2及MMP-14联合预测的ROC曲线下面积、敏感度及特异度均高于三者单独预测的面积、敏感度及特异度,差异均有统计学意义(均P<0.05)。结论FOXO3、XPNPEP2及MMP-14在结直肠癌组织中均表达异常,是引起结直肠癌患者不良预后的独立危险因素,且三者联合检测能显著提高预测能力,对评估结直肠癌患者预后具有较高的临床价值。

Objective To explore the significance of forkhead box protein O3(FOXO3),amin-opeptidase P2(XPNPEP2)and matrix metalloproteinase-14(MMP-14)for predicting the poor prognosis of colorectal cancer.Methods The cancer tissues and normal paracancerous tissues were corrected from 77 patients with colorectal cancer admitted to The First Affiliated Hospital of Xi'an Medical College from Januar-y 2018 to December 2019.According to the prognosis of patients with colorectal cancer,they were divided into a good prognosis group(32 patients)and a poor prognosis group(45 patients).Clinical data were compared between the two groups.The risk factors for the poor prognosis were analyzed,and its predictive value was assessed by receiver operating characteristic(ROC)curve analysis.Results Compared with normal tissues,the expression of FOXO3 decreased and the expression XPNPEP2 and MMP-14 increased in cancer tissues(all P<0.05).Univariate analysis showed that the depth of invasion,tumor node metastasis(TNM)stage,low expression of FOXO3 and high expression of XPNPEP2 and MMP-14 were the single fac-tors for the poor prognosis of patients(all P<0.05).Logistic regression analysis showed that low expres-sion of FOXO3 and high expression of XPNPEP2 and MMP-14 were independent risk factors for poor prognosis in patients with colorectal cancer(all P<0.05).The ROC curve analysis showed the area under the ROC curve,the sensitivity and the specificity of the combination detection of FOXO3,XPNPEP2 and MMP-14 were higher than each of the single detection of FOXO3,XPNPEP2 and MMP-14(all P<0.05).Con-clusion FOXO3,XPNPEP2 and MMP-14 are abnormally expressed in colorectal cancer tissues,which are independent risk factors for the poor prognosis of colorectal cancer patients,and their combination detection can significantly improve the predictive ability,which is of high clinical value for evaluating the prognosis of colorectal cancer.