口腔鳞癌患者PLK1、caspase-3及Ki-67变化及临床意义

Changes and clinical significance of PLK1,caspase-3 and Ki-67 in patients with oral squamous cell carcinoma

目的 探讨口腔鳞癌患者保罗样激酶1(PLK1)、凋亡同胱氨酸蛋白-3(Caspase-3)、细胞增殖核抗原(Ki-67)变化及临床意义。方法 选取2017年3月至2019年3月河北北方学院附属第一医院收治的104例口腔鳞状细胞癌组织作为癌组织组,选取远离癌组织3 cm的癌旁组织作为癌旁组织组,对比两组PLK1、caspase-3及Ki-67阳性率,随访2年,记录预后生存、死亡率,分析三项指标与患者预后的关系。绘制受试者工作特征曲线(ROC),评估联合三项指标(PLK1+caspase-3+Ki-67)检测对口腔鳞癌患者预后死亡的预测价值。结果 癌组织组PLK1、caspase-3及Ki-67阳性表达率均明显高于癌旁组织组,差异均有统计学意义(P<0.05)。本研究随访率100%,随访期间死亡63例(60.58%),生存41例(39.42%)。PLK1、caspase-3及Ki-67阳性表达的患者死亡率显著高于PLK1、caspase-3及Ki-67阴性表达的患者,差异有统计学意义(P<0.05)。临床分期(Ⅲ~Ⅵ期)、有淋巴结转移、分化程度中-低分化、单一手术治、治疗依从性佳、PLK1(阳性)、caspase-3(阳性)及Ki-67(阳性)为影响口腔鳞状细胞癌患者预后生存的独立危险因素(P<0.05)。三项指标(PLK1+caspase-3+Ki-67)联合检测灵敏度(0.924)、特异度(0.947)、AUC(0.969)均高于单一指标检测(P<0.05)。结论 PLK1、caspase-3及Ki-67与口腔鳞状细胞癌发生、预后相关,临床可加强联合三项指标检测,提高口腔鳞状细胞癌早期诊断率,以评估患者预后。

Objective To investigate the changes and clinical significance of Paul-like kinase 1(PLK1),apoptotic homocysteine protein-3(Caspase-3)and proliferating nuclear antigen(Ki-67)in patients with oral squamous cell carcinoma. Methods 104 cases of oral squamous cell carcinoma admitted to the First Affiliated Hospital of Hebei North University from March 2017 to March 2019 were selected as the cancer tissue group,and the paracancerl tissue 3 cm away from the cancer tissue was selected as the paracancer tissue group,the positive rates of PLK1,caspase-3 and Ki-67 were compared between the two groups,followed up for 2years,and recorded the prognosis survival,mortality,and analyzed the relationship between the three indicators and patient prognosis. Receiver operating characteristic curve(ROC)was drawn to evaluate the predictive value of combined three indicators(PLK1+caspase-3+Ki-67)in the prognosis and death of patients with oral squamous cell carcinoma. Results The positive expression rates of PLK1,caspase-3 and Ki-67 in the cancer tissue group were significantly higher than those in the para-cancer tissue group,and the differences were statistically significant(P<0.05). The follow-up rate of this study was 100%. During the follow-up period,63cases(60.58%)died and 41 cases(39.42%)survived. The mortality rate of patients with positive expression of PLK1,caspase-3 and Ki-67 was significantly higher than that of patients with negative expression of PLK1,caspase-3 and Ki-67,and the difference was statistically significant(P<0.05). Clinical stage(Ⅲ~Ⅵ),lymph node metastasis,medium to low differentiation,single surgical treatment,good treatment compliance,PLK1(positive),caspase-3(positive)and Ki-67(positive)were independent risk factors affecting the prognosis and survival of patients with oral squamous cell carcinoma(P<0.05). The combined detection sensitivity(0.924),specificity(0.947)and AUC(0.969)of three indicators(PLK1+caspase-3+Ki-67)were higher than those of single indicator detection(P<0.05). Conclusion PLK1,caspase-3 and Ki-67 are related to the occurrence and prognosis of oral squamous cell carcinoma. The clinical combination of the three indicators can be strengthened to improve the early diagnosis rate of oral squamous cell carcinoma to evaluate the prognosis of patients.