黑色素瘤特异性抗原在胃癌组织中的表达及对胃癌肝转移和预后的影响

Expression of PRAME in gastric cancer tissue and its effect on liver metastasis and prognosis of gastric cancer

目的 检测胃癌组织中黑色素瘤特异性抗原(PRAME)的表达,分析其对胃癌肝转移的预测价值及预后的影响。方法 2016年1月至2018年10月在我院接受治疗的胃癌无肝转移患者142例,分析影响胃癌肝转移的独立危险因素,检测PRAME高表达预测胃癌肝转移的临床价值,比较PRAME高表达胃癌肝转移者与PRAME低表达胃癌肝转移者术后3年生存率。结果 术后3年发生肝转移34例(23.9%),无肝转移108例。PRAME在胃癌组织中低表达65例,高表达77例。多因素Logistic回归分析显示淋巴结转移、血管侵犯、CA72-4>6.7μg/L和PRAME高表达均为影响胃癌肝转移的独立危险因素。PRAME高表达预测肝转移的曲线下面积为0.896,敏感度为0.836,特异度为0.735,对肝转移具有一定临床预测价值(P<0.05)。肝转移PRAME高表达组生存率为18.5%,低于肝转移PRAME低表达组50.0%(P<0.05)。结论 胃癌组织中PRAME高表达为肝转移的独立危险因素,对肝转移有一定预测价值并影响其预后。

Objective To detect the expression of melanoma-specific antigen(PRAME) in gastric cancer tissues, and analyze its predictive value of gastric cancer liver metastasis and prognosis of gastric cancer.Methods 142 patients with gastric cancer without liver metastases in our hospital from January 2016 to October 2018 was performed. The independent risk factors affecting liver metastasis of gastric cancer were analyzed. The clinical value of high PRAME expression in predicting liver metastasis of gastric cancer was explored. The 3-year survival rates between patients with liver metastasis of gastric cancer with high PRAME expression and those with liver metastasis of gastric cancer with low PRAME expression were compared.Results There were 34 cases(23.9 %) with liver metastasis after 3 years of operation, and 108 cases without liver metastasis. There were 65 cases with PRAME low expression and 77 cases with PRAME high expression in gastric cancer tissues. Multivariate logistic regression analysis showed that lymph node metastasis, vascular invasion, high expressions of CA72-4(>6.7 μg/L) and PRAME were independent risk factors for liver metastasis. The area under the ROC curve of PRAME high expression in predicting liver metastasis was 0.896, the sensitivity was 0.836, and the specificity was 0.735, which has certain clinical predictive value for liver mestastasis(P<0.05). The survival rate of the liver metastasis group with high PRAME expression was 18.5%, which was lower than that of metastasis group with low PRAME expression(50.0%)(P<0.05).Conclusions The high expression of PRAME in gastric cancer tissue is an independent risk factor for gastric cancer liver metastasis. It has a certain predictive value for gastric cancer liver metastasis and prognosis.