NKD1在结直肠癌中的表达及其在预测肝转移中的价值

Expression of of NKD1 in colorectal cancer and its value in predicting liver metastasis

目的探讨裸角质膜同源蛋白(NKD1)在结直肠癌(CRC)中的表达及其在预测肝转移中的价值。方法选取2018年12月至2021年12月江苏省人民医院浦口分院接受根治性切除术的CRC肝转移患者44例为观察组,同期选取36例接受根治性切除术的CRC无肝转移患者为对照组。收集癌组织及癌旁组织(距癌肿5 cm肠粘膜),采用免疫组化法检测NKD1表达,分析癌组织NKD1表达与病理特征的相关性,Logistic回归分析CRC肝转移影响因素。结果癌组织NKD1阳性表达率低于癌旁组织,差异有统计学意义(χ^(2)=35.153,P<0.05);CRC患者癌组织中NKDl阳性表达率与年龄、性别、肿瘤直径、病变部位、浸润深度无关(P>0.05),与Duke分期、分化程度、淋巴结转移有关(χ^(2)=42.725,14.266,16.419;P<0.05);Logistic回归模型分析显示,浸润浆膜、Duke分期C+D期、低分化、淋巴结转移均为CRC患者肝转移独立危险因素,癌组织NKD1阳性表达为CRC患者肝转移独立保护因素(P<0.05)。结论CRC患者NKDl阳性表达率显著降低,可能与CRC侵袭与转移有关,且可作为肝转移的预测标志物。

Objective To investigate the expression of naked keratinocyte homologous protein(NKD1)in colorectal cancer(CRC)and its value in predicting liver metastasis.Methods Forty-four patients with CRC liver metastases who received radical resection from December 2018 to December 2021 in Pukou Branch of Jiangsu Provincial People’s Hospital were selected as the observation group,and 36 CRC patients without liver metastasis who received radical resection during the same period were selected for the control group.Cancer tissues and adjacent tissues(intestinal mucosa 5 cm away from the tumor)were collected,and the expression of NKD1 was detected by immunohistochemistry.The correlation between the expression of NKD1 in cancer tissues and pathological characteristics was analyzed,and the influencing factors of CRC liver metastasis were analyzed by logistic regression.Results The positive expression rate of NKD1 in cancer tissues was lower than that in adjacent tissues(χ^(2)=35.153,P<0.05).The positive expression rate of NKD1 in cancer tissues of CRC patients was not related to age,gender,tumor diameter,lesion location,and depth of invasion(P>0.05),and was associated with Duke staging,differentiation degree,and lymph node metastasis(χ^(2)=42.725,14.266,16.419;P<0.05).Logistic regression model analysis showed that serosa infiltration,Duke stage C+D,poorly differentiated,and lymph node metastasis were independent risk factors for liver metastasis in CRC patients,and positive expression of NKD1 in cancer tissue was an independent protective factor for liver metastasis in CRC patients(P<0.05).Conclusion The positive expression rate of NKD1 in CRC patients is significantly reduced,which may be related to the invasion and metastasis of CRC and can be used as a predictive marker for liver metastasis.