Claudin-4、HSF1及磷酸甘油酸激酶1与前列腺癌病理特征、预后的关系研究

Study on the relationships between the levels of Claudin-4, HSF1 and phosphoglycerate kinase 1 and the pathological characteristics and prognosis of patients with prostate cancer

目的 探讨紧密连接蛋白-4(Claudin-4)、热休克因子(HSF1)及磷酸甘油酸激酶1(PGK1)与前列腺癌病理特征、预后的关系。方法 回顾性分析2013年12月—2018年12月本院收治的114例前列腺癌患者的临床资料。将114份前列腺癌组织设为观察组,经穿刺活检选取上述患者远离前列腺癌3 cm的癌旁正常组织为对照组。对比两组Claudin-4、HSF1、PGK1表达差异;分析三者与前列腺癌患者病理特征的关系;随访2年,了解预后;Logistic回归模型分析影响前列腺癌患者2年预后的相关因素;绘制受试者工作特征曲线(ROC),分析联合三项指标检测对前列腺癌患者预后死亡的预测价值。结果 (1)观察组Claudin-4、HSF1、PGK1阳性表达率均显著高于对照组Claudin-4、HSF1、PGK1阳性表达率,比较差异具有统计学意义(P<0.05)。(2)分化程度越低、TNM分期越高、有骨转移、Gleason评分越高的前列腺癌患者Claudin-4、HSF1、PGK1阳性表达率显著高于Claudin-4、HSF1、PGK1阴性表达率,比较差异具有统计学意义(P<0.05)。(3)Claudin-4、HSF1及PGK1阳性表达的患者死亡率显著高于Claudin-4、HSF1及PGK1阴性表达的患者,比较差异具有统计学意义(P<0.05)。(4)Claudin-4(表达阳性)、HSF1(表达阳性)、PGK1(表达阳性)、肿瘤直径(≥3 cm)、分化程度(低分化)、TNM分期(Ⅲ-Ⅳ期)、有骨转移、Gleason评分(≥7分)为影响前列腺癌患者预后死亡的独立危险因素(P<0.05)。(5)联合Claudin-4、HSF1、PGK1检测灵敏度、特异度、AUC分别为0.933、0.948、0.989,均显著高于单一指标检测(P<0.05)。结论 Claudin-4、HSF1及PGK1与前列腺癌患者病情进展、预后密切相关,临床可通过加强联合三者检测评估患者预后。

Objective To explore the relationships between the levels of Claudin-4(Claudin-4), Heat shock factor(HSF1) and Recombinant Phosphoglycerate Kinase 1(PGK1), and the pathological characteristics and prognosis of patients with prostate cancer.Methods Clinical data of 114 patients with prostate cancer admitted to our hospital from December 2013 to December 2018 were retrospectively analyzed. 114 prostate cancer tissue samples were set as the observation group. The normal tissue adjacent to the cancer 3 cm away from the prostate cancer was selected as the control group. The differences in the expression of Claudin-4, HSF1 and PGK1 between the two groups were compared. The relationship between the levels of the three indicators and the pathological characteristics of patients with prostate cancer was analyzed. The patients were followed up for 2 years to understand the prognosis. Logistic regression model was used to analyze the related factors that affected the 2-year prognosis of patients with prostate cancer. The receiver operating characteristic curve( ROC) was drawn to analyze the value of the combined detection of three indicators in predicting the prognostic death of patients with prostate cancer.Results The positive expression rates of Claudin-4,HSF1,and PGK1 in the observation group were significantly higher than those in the control group, and the differences were statistically significant( P<0.05). The positive expression rate of Claudin-4,HSF1and PGK1 in patients with lower differentiation,higher TNM stage,bone metastasis,and higher Gleason score were significantly higher than the negative expression rate of Claudin-4,HSF1 and PGK1,and the differences were statistically significant( P<0.05). The mortality of patients with positive expression of Claudin-4,HSF1 and PGK1 was significantly higher than that of patients with negative expression of Claudin-4,HSF1 and PGK1,and the difference was statistically significant( P<0.05). Claudin-4( positive expression),HSF1( positive expression),PGK1( positive expression),tumor diameter( ≥ 3 cm),degree of differentiation( low differentiation),TNM stage( Ⅲ-Ⅳ),bone metastasis,Gleason score( ≥ 7 points) were independent risk factors that affected the prognostic death of patients with prostate cancer( P<0.05). The sensitivity,specificity,and AUC of the combined detection of Claudin-4,HSF1,and PGK1 were 0. 933,0. 948,and 0. 989,respectively,which were significantly higher than those of single detection( P< 0. 05). Conclusions Claudin-4,HSF1 and PGK1 are closely related to the progression and prognosis of patients with prostate cancer. In clinic,the prognosis of patients could be assessed by strengthening the combined testing of the three indicators.