膀胱癌病人癌组织中Dickkopf相关蛋白2的表达及与预后的相关性

Expression of Dickkopf-related protein 2 in cancer tissues of patients with bladder cancer and its correlation with prognosis

目的 探讨膀胱癌病人癌组织中Dickkopf相关蛋白2(DKK2)的表达及与预后的关系。方法 2016年5月-2018年6月我院收治的拟行手术治疗的膀胱癌病人86例,收集病人膀胱癌组织标本和癌旁组织(距癌组织≥5 cm),比较癌组织、癌旁组织中DKK2表达情况。分析癌组织中DKK2表达与临床病理特征的关系。Cox回归分析影响膀胱癌病人预后的因素。分析癌组织中DKK2表达与膀胱癌病人预后的关系。结果 膀胱癌组织DKK2阴性表达率高于癌旁组织,差异有统计学意义(P<0.05)。不同性别、年龄、体质量指数(body mass index, BMI)、吸烟、饮酒、肿瘤数量膀胱癌病人癌组织中DKK2阴性表达率比较,差异无统计学意义(P>0.05);肿瘤最大径≥3 cm、临床分期Ⅲ-Ⅳ期、有淋巴结转移、低分化、脉管侵犯膀胱癌病人癌组织中DKK2阴性表达率分别高于肿瘤最大径<3 cm、临床分期Ⅰ-Ⅱ期、无淋巴结转移、中/高分化、无脉管侵犯病人,差异有统计学意义(P<0.05)。86例膀胱癌病人术后随访3年,共失访5例,81例病人中19例死亡,病死率为23.46%。Cox回归分析显示,临床分期、淋巴结转移、分化程度、DKK2阴性是影响膀胱癌病人预后的独立影响因素(OR=3.018、2.267、3.184、4.645,P<0.05)。截止随访结束,DKK2阳性、DKK2阴性膀胱癌病人存活率分别为94.44%、71.43%。DKK2阳性表达病人与DKK2阴性表达病人生存曲线比较,差异有统计学意义(P<0.05)。结论 膀胱癌组织中DKK2阴性表达率较高,DKK2表达与膀胱癌病人肿瘤最大径、临床分期、淋巴结转移、分化程度及脉管侵犯及预后均具有一定的相关性,监测其表达情况对膀胱癌病人预后评估具有重要参考价值。

Objective To investigate the expression of Dickkopf-related protein 2(DKK2) in cancer tissues of patients with bladder cancer and its relationship with prognosis.Methods Eighty-six patients with bladder cancer who were treated in our hospital from May 2016 to June 2018 were selected for surgical treatment of bladder cancer, and bladder cancer tissue specimens and adjacent tissues(≥5 cm from the cancer tissue) were collected.Compare the expression of DKK2 in cancerous tissues and adjacent tissues.Analyze the relationship between DKK2 expression in cancer tissues and clinicopathological characteristics.Cox regression analysis of multiple factors affecting the prognosis of bladder cancer patients.To analyze the relationship between the expression of DKK2 in cancer tissues and the prognosis of bladder cancer patients.Results The negative expression rate of DKK2 in bladder cancer tissue was higher than that in adjacent tissues(P<0.05).There was no significant difference in the negative expression rate of DKK2 in cancer tissues of bladder cancer patients with different gender, age, BMI,smoking, drinking, and the number of tumors(P>0.05).The maximum diameter of the tumor was ≥3 cm, the clinical stage Ⅲ to Ⅳ,there was The negative expression rate of DKK2 in the cancer tissues of patients with lymph node metastasis, poorly differentiated, and vascular invasion of bladder cancer is higher than that in patients with tumors with a maximum diameter of <3 cm, clinical stages Ⅰ to Ⅱ,no lymph node metastasis, moderate/well differentiated, and no vascular invasion.The difference was statistically significant(P<0.05).86 patients with bladder cancer were followed up for 3 years, and 5 cases were lost to follow-up.Of the remaining 81 patients, 19 died, with a mortality rate of 23.46%.Cox regression analysis showed that clinical stage, lymph node metastasis, degree of differentiation, and negative expression rate of DKK2 were independent factors affecting the prognosis of bladder cancer patients(OR=3.018,2.267,3.184,4.645,P<0.05).By the end of the follow-up, the survival rates of patients with DKK2-positive and DKK2-negative bladder cancer were 94.44% and 71.43%,respectively.The survival curve of patients with positive expression of DKK2 and patients with negative expression of DKK2 were compared, and the difference was statistically significant(P<0.05).Conclusion The negative expression rate of DKK2 in cyst carcinoma tissues is relatively high.The expression of DKK2 has a certain correlation with tumor diameter, clinical stage, lymph node metastasis, degree of differentiation, vascular invasion and prognosis in patients with bladder cancer.Monitoring its expression is beneficial to patients with bladder cancer Prognosis evaluation has important reference value.