TXNDC17表达与子宫内膜浆液性癌患者临床病理特征及预后的关系研究

TXNDC17 protein overexpression in uterine papillary serous carcinoma is associated with clinicopathological characteristics and prognosis

目的探讨TXNDC17表达与子宫内膜浆液性癌(UPSC)患者的临床病理特征及预后的关系。方法收集2003—2016年在浙江大学医学院附属妇产科医院收治的55例UPSC患者的临床病理资料,进行回顾性随访研究。通过免疫组织化学技术分别检测UPSC患者TXNDC17和自噬分子BECN1的蛋白表达水平。采用Kaplan‑Meier法计算累积生存率,采用log‑rank检验比较不同特征患者累积生存率差异,采用多因素Cox比例风险回归模型分析TXNDC17表达与UPSC患者预后的关系。结果55例患者年龄M[(Q1,Q3)]为63(49,79)岁,其中有43.6%(24例)已经是晚期(Ⅲ/Ⅳ期),32.7%(18例)患者浸润深肌层。28例(50.9%)患者TXNDC17高表达,自噬分子BECN1表达不同的患者,其TXNDC17表达也不同,差异有统计学意义(P=0.023)。TXNDC17和BECN1共同高表达患者国际妇产科联盟(FIGO)分期更高、肌层浸润深度更深(P=0.013、0.009)。TXNDC17高表达(37.4%比91.5%)、FIGOⅢ/Ⅳ期(44.1%比70.1%)、深肌层浸润(36.1%比75.4%)、BECN1高表达(0比83.0%)患者的累积生存率均较低(均P<0.05)。多因素分析结果显示,肌层浸润深度、TXNDC17表达与UPSC患者治疗后是否生存相关,HR值(95%CI)分别为4.163(1.392~12.453)、6.900(1.532~31.081)(均P<0.05)。结论TXNDC17的高表达与UPSC的不良预后相关;TXNDC17和BECN1共同高表达患者多为FIGOⅢ/Ⅳ期和深肌层浸润。TXNDC17可能是UPSC治疗中1个潜在的预测因子或靶点。

Objective To analyze clinicopathological characteristics of patients with uterine papillary serous carcinoma(UPSC)in China,and investigate roles of TXNDC17 protein in UPSC clinicopathological characteristics and prognosis.Methods Fifty‑five patients with UPSC treated in Women′s Hospital School of Medicine Zhejiang University from 2003 to 2016 were analysed retrospectively.Immunohistochemistry(IHC)were performed to TXNDC17 and BECN1(Beclin 1 protein,a key regulator of autophagy)protein expression respectively.Kaplan‑Meier was used to calculate the cumulative survival rate,Log‑rank test was performed to compare the difference in cumulative survival rate among patients with different clinicopathological characteristics,and Cox regression model was used to analyze the related between TXNDC17 expression and prognosis of UPSC patients.Results The median age of the 55 UPSC patients was 63(49,79)years,43.6%(24/55)with late stages(stageⅢ/Ⅳ),and 32.7%(18/55)exhibiting more than half of myometrium invasion were enrolled.Notably,28(50.9%)patients had TXNDC17 protein overexpression,and associated with BECN1 overexpression(P=0.023).Besides,co‑expression of TXNDC17 and BECN1 occurred at an advanced stage and deep myometrial invasion(P=0.013,0.009).The cumulative survival rate of TXNDC17 overexpression(37.4%vs 91.5%),FIGOⅢ/Ⅳstage(44.1%vs 70.1%),deep myometrium invasion(36.1%vs 75.4%)and BECN1 overexpression(0 vs 83.0%)patients was low(P<0.05).The multivariate proportional hazards model revealed that myometrial invasion and TXNDC17 overexpression were associated with prognosis of UPSC patients.Conclusions This study shows that TXNDC17 overexpression is associate with poor survival in UPSC patients.Co‑expression of TXNDC17 and BECN1 shows characteristics of advanced stages and deep myometrial invasion.TXNDC17 may be a potential predictor or target in UPSC therapeutics..