丙酮酸脱氢酶E1α亚单位、转录激活反应RNA结合蛋白1在表皮生长因子受体突变晚期非小细胞肺癌中的表达及对患者预后的影响

Expression of pyruvate dehydrogenase complex E1α subunit and transcriptional activation RNA binding protein 1 in epidermal growth factor receptor mutated advanced non-small cell lung cancer and their impact on prognosis

目的探讨丙酮酸脱氢酶E1α亚单位(PDHA1)、转录激活反应RNA结合蛋白1(TARBP1)在表皮生长因子受体(EGFR)突变晚期非小细胞肺癌(NSCLC)中的表达及对患者预后的影响。方法取95例接受靶向治疗的EGFR突变晚期NSCLC患者的肿瘤组织,免疫组化法检测PDHA1、TARBP1蛋白的表达情况,并分析其与患者临床特征的关系。随访3年,记录患者的总生存率,NSCLC患者预后的影响因素采用Cox风险比例回归模型分析。结果95例NSCLC患者肿瘤组织中,PDHA1阳性表达率为45.26%,阴性表达率为54.74%;TARBP1阳性表达率为74.74%,阴性表达率为25.26%。分化程度为中低分化、淋巴结转移NSCLC患者肿瘤组织中PDHA1蛋白的阳性表达率较低、TARBP1蛋白的阳性表达率较高。至随访结束,95例NSCLC患者病死67例,生存28例。PDHA1阳性表达患者总生存率为44.2%,明显高于PDHA1阴性表达患者的17.3%(P﹤0.01);TARBP1阳性表达患者的总生存率为18.3%,明显低于TARBP1阴性表达患者的62.5%(P﹤0.01)。多因素Cox回归分析结果显示,分化程度为中低分化、有淋巴结转移、PDHA1表达阴性、TARBP1表达阳性均是NSCLC患者预后的独立危险因素(P﹤0.05)。结论接受靶向治疗的EGFR突变晚期NSCLC患者肿瘤组织中PDHA1阴性表达率较低、TARBP1阳性表达率较高,且PDHA1阴性表达、TARBP1阳性表达患者的预后较差。

Objective To investigate the expression of pyruvate dehydrogenase complex E1αsubunit(PDHA1)and transcriptional activation RNA binding protein 1(TARBP1)in epidermal growth factor receptor(EGFR)mutated ad-vanced non-small cell lung cancer(NSCLC)and their impact on the prognosis of patients.Method The tumor tissues of 95 patients with EGFR-mutant advanced NSCLC who received targeted therapy were selected,and the expression of PDHA1 and TARBP1 proteins were detected by immunohistochemistry,and the relationship between them and the clini-cal characteristics of the patients was analyzed.Followed up for 3 years,and the overall survival rate of the patients was recorded.The influencing factors of the prognosis and survival of NSCLC patients were analyzed by Cox hazards propor-tional regression model analysis.Result In the tumor tissues of 95 NSCLC patients,the positive expression rate of PDHA1 was 45.26%and the negative expression rate was 54.74%;the positive expression rate of TARBP1 was 74.74%and the negative expression rate was 25.26%.The positive expression rate of PDHA1 protein was lower and that of TARBP1 protein was higher in tumor tissue of NSCLC patients with medium and low differentiation and lymph node me-tastasis.By the end of follow-up,67 of 95 NSCLC patients died and 28 survived.The overall survival rate of patients with positive PDHA1 expression was 44.2%,which was significantly higher than 17.3%of patients with negative PDHA1 expression(P<0.01).The overall survival rate of patients with positive TARBP1 expression was 18.3%,which was significantly lower than 62.5%of patients with negative TARBP1 expression(P<0.01).Multivariate Cox regression analysis showed that moderate and low differentiation,lymph node metastasis,negative PDHA1 expression,and positive TARBP1 expression were independent risk factors affecting the prognosis of NSCLC patients(P<0.05).Conclusion The tumor tissue of patients with EGFR-mutant advanced NSCLC who received targeted therapy had a lower negative expression rate of PDHA1 and a higher positive expression rate of TARBP1,and the prognosis of patients with PDHA1 neg-ative expression and TARBP1 positive expression was poor.