MTDH、Ets-1及p21WAF1蛋白在鼻咽癌组织中的表达及临床意义

EXPRESSION AND CLINICAL SIGNIFICANCE OF MTDH,ETS-1 AND P21WAF1 PROTEINS IN NASOPHARYNGEAL CARCINOMA

目的 分析异粘蛋白(MTDH)、转录调节因子-1(Ets-1)及细胞周期调控蛋白(p21 WAF1)蛋白在鼻咽癌(NPC)组织中的表达及临床意义。方法 收集2017年5月—2020年5月该院收治的鼻咽癌患者113例,以患者术中癌组织病理切片作为NPC组,距肿瘤切缘至少0.5 cm处无癌变组织作为对照组,另选取鼻咽黏膜慢性炎症患者鼻咽黏膜慢性炎组织作为炎症组109例。对比不同组织中MTDH、Ets-1及p21 WAF1蛋白表达情况,分析MTDH、Ets-1及p21 WAF1蛋白与NPC患者临床病理参数之间的关系,采用多元Logistic回归分析影响NPC患者预后生存的危险因素。结果 随访截止至2021年5月31日,无失访,随访率为100%。113例患者中有预后良好有75例,预后不良38例,预后不良包括死亡、复发、转移。NPC组中MTDH、Ets-1表达阳性情况明显高于对照组及炎症组,p21 WAF1蛋白表达低于对照组及炎症组(P<0.05);MTDH表达情况在临床分期、淋巴结转移中比较差异有统计学意义(P<0.05),在性别、年龄、病理分级、生存情况中表达差异无统计学意义(P>0.05);Ets-1表达情况在淋巴结转移、临床分期、病理分级中表达差异有统计学意义(P<0.05);p21WAF1在性别、年龄、临床分期、淋巴结转移病理分级中表达差异无统计学意义(P>0.05);经单因素分析可知淋巴结转移、临床分期、病理分级、MTDH、Ets-1、p21WAF1为影响NPC患者预后生存的危险因素(P<0.05);经非条件多因素Logistic回归模型分析得,淋巴结转移、临床分期为IIIIV其、非角化型未分化癌、MTDH、Ets-1、p21WAF1表达异常影响NPC患者生存的独立危险因素(P<0.05)。结论 MTDH、Ets-1在NPC患者组织中表达上升,p21WAF1蛋白表达下调;MTDH、Ets-1、p21WAF1与NPC发生、发展以及预后密切相关。

Objective To analyze the expression and clinical significance of Heteromyxin(MTDH),transcription regulator-1(Ets-1) and cell cycle regulatory protein(p21 WAF1) proteins in nasopharyngeal carcinoma(NPC) tissues.Methods A total of one hundred and thirteen patients with nasopharyngeal carcinoma admitted to our hospital from May 2017 to May 2020 were collected.Pathological sections of intraoperative cancer tissues were used as NPC group, and non-cancerous tissues at least 0.5 cm from tumor resection margin were used as control group, and 109 patients with chronic inflammation of the nasopharyngeal mucosa were selected as the inflammation group.The expressions of MTDH,Ets-1 and p21 WAF1 proteins in different tissues were compared, and the relationship between the levels of MTDH,Ets-1 and p21 WAF1 proteins and the clinicopathological parameters of NPC patients was analyzed.Multivariate Logistic regression was used to analyze the risk factors affecting the prognostic survival of NPC patients.Results There was no loss of follow-up from May 31,2020 to May 31,2021,and the follow-up rate was 100%.Among 113 patients, 75 had good prognosis and 38 had poor prognosis, including death, recurrence and metastasis.The positive expression of MTDH andEts-1 in the NPC group was significantly higher than that of the control group and the inflammation group, and the expression of p21 WAF1 protein was lower than that of the control group and the inflammation group(P<0.05).The expression of MTDH was different in patients with different clinical stages and lymph node metastasis(P<0.05),and there was no significant difference in patients with different gender, age, pathological grade, and survival(P>0.05).The expression of Ets-1 was different in patients with different lymph node metastasis, clinical stage, and pathological grade(P<0.05).There was no significant difference in the expression of p21 WAF1 of patients with different gender, age, clinical stage, and pathological grade of lymph node metastasis(P>0.05).Univariate analysis showed that lymph node metastasis, clinical stage, pathological grade, MTDH,Ets-1,and p21 WAF1 were single factors affecting the prognostic survival of NPC patients(P<0.05).Unconditional multivariate logistic regression analysis showed that lymph node metastasis, clinical staging of III-IV,non-keratinizing undifferentiated carcinoma, abnormal expression of MTDH,Ets-1,and p21 WAF1 were independent risk factors affecting the survival of NPC patients(P<0.05).Conclusion The expression of MTDH and Ets-1 increases in the tissues of NPC patients, while the expression of p21 WAF1 protein decreases.MTDH,Ets-1,and p21 WAF1 are closely related to the occurrence, development and prognosis of NPC.