PPARα在肾透明细胞癌组织中的表达及其与预后的关系

Expression of PPARαin renal clear cell carcinoma and its relationship with prognosis

目的:探讨肾癌组织中过氧化物酶体增殖物激活受体α(PPARα)的表达及其与临床病理特征和生存率的关系。方法:纳入75例于2014至2019年间在我院接受了根治性肾切除术并经组织学证实的肾透明细胞癌患者,运用免疫组织化学方法检测这些患者的癌组织和癌旁组织中PPARα的表达,并结合临床病理资料分析PPARα表达水平与患者TNM分期和Fuhrman分级的关系。通过Kaplan-Meier生存分析及多因素COX回归分析表达与预后的关系。结果:42.67%(32/75)的患者癌组织中PPARα表达为高水平,而在癌旁组织中有85.33%(64/75)患者PPARα表达均为高水平,组间比较差异有统计学意义(P<0.05)。PPARα的表达水平与TNM分期(P=0.01)、Fuhrman分级(P<0.025)、BMI(P=0.0001),术前血清胱抑素C(P=0.0001)、抽烟史(P=0.035)、术前碱性磷酸酶(P=0.012)有关联,但与性别(P=0.127)、年龄(P=0.815)、肿瘤大小(P=0.484)、民族(P=0.621)、肿瘤左右侧别发生差异(P=0.270)、诊断本病前有无出现相关临床症状(P=0.210)、有无淋巴结转移(P=0.06)、糖尿病史(P=0.233)、高血压史(P=0.561)无相关。截至2020年03月,有75例患者完成随访。Kaplan-Meier分析显示,PPARα低表达患者总生存时间和无瘤生存时间均低于PPARα高表达患者,差异有统计学意义(P<0.05)。多因素COX回归分析显示,患者总生存时间及无瘤生存时间与PPARα的表达水平有关(P<0.05)。结论:PPARα在肾透明细胞癌组织中呈低表达,表达水平与临床分期、分级、体质量指数、碱性磷酸酶、血清胱抑素C、抽烟史以及患者预后密切相关。

Objective:To investigate the relationship between the expression of PPARα(peroxisome proliferator-activated receptor alpha)and clinicopathological characteristics and survival rate in renal cell carcinoma.Methods:Seventy-five patients with renal clear cell carcinoma who underwent a radical nephrectomy in our hospital between 2014 and 2019 were histologically confirmed.The cancer tissues and adjacent cancers of these patients were detected by immunohistochemistry.The expression of PPARαin tissues and the relationship between PPARαexpression level and TNM staging and Fuhrman grading were analyzed in combination with clinical pathological data.Kaplan-Meier survival analysis and multivariate COX regression were used to analyze the relationship between expression and prognosis.Results:42.67%(32/75)of patients had high levels of PPARαexpression in cancer tissues,while 85.33%(64/75)of patients with adjacent tissues had high levels of PPARαexpression.The difference between groups was statistically significant(P<0.05).PPARαexpression level and TNM staging(P=0.01),Fuhrman classification(P<0.025),BMI(P=0.0001),preoperative serum cystatin C(P=0.0001),smoking history(P=0.035),surgery Pre-alkaline phosphatase(P=0.012)was related,but there were differences in gender(P=0.127),age(P=0.815),tumor size(P=0.484),ethnicity(P=0.621),left and right sides of the tumor(P=0.270),whether relevant clinical symptoms occurred before the diagnosis of the disease(P=0.210),whether there was lymph node metastasis(P=0.06),history of diabetes(P=0.233),history of hypertension(P=0.561)not related.As of March 2020,75 patients have completed follow-up.Kaplan-Meier analysis showed that the overall survival time and tumor-free survival time of patients with low PPARαexpression were lower than those with high PPARαexpression,and the difference was statistically significant(P<0.05).Multivariate COX regression analysis showed that the overall survival time and tumor-free survival time were related to the expression level of PPARα(P<0.05).Conclusion:PPARαis lower in renal clear cell carcinoma tissues,and the expression level is closely related to clinical stage,grade,body mass index,alkaline phosphatase,serum cystatin C,smoking history and patient prognosis.