PAR-1、PAR-2在先天性巨结肠组织中的表达及其与预后的相关性分析

Expression of PAR-1 and PAR-2 in Hirschsprung's Disease and its Correlation with Prognosis

[目的]探讨蛋白酶激活受体-1(PAR-1)、蛋白酶激活受体-2(PAR-2)在先天性巨结肠(HSCR)组织中表达及其与预后的关系.[方法]选取2014年1月至2019年1月在周至县中医医院接受根治性手术治疗的100例HSCR患儿,留取HSCR病变(痉挛段)组织样本和病变旁(距病变2 cm以上)正常肠道黏膜组织.采用免疫组化检测HSCR病变组织样本和正常肠道黏膜组织中PAR-1和PAR-2表达情况,采用荧光定量PCR技术检测PAR-1 mRNA、PAR-2 mRNA表达水平,采用Pearson法分析PAR-1、PAR-2与Kricken-beck评分及血清IL-6、TNF-α水平的相关性,采用Logistic多因素分析影响HSCR患儿预后不良的危险因素.[结果]病变组织中PAR-1、PAR-2阳性表达率高于病变旁组织,差异有统计学意义(P<0.05).与病变旁组织相比,病变组织中PAR-1 mRNA、PAR-2 mRNA表达水平及PAR-1、PAR-2蛋白水平显著升高(P<0.05);预后较差组患儿PAR-1、PAR-2及血清IL-6、TNF-α水平明显高于预后良好组及预后较优组(P<0.05),预后良好组高于预后较优组(P<0.05).Pearson结果显示,PAR-1、PAR-2与Krickenbeck评分均呈负相关(均P<0.05),与IL-6、TNF-α呈正相关(均P<0.05).多因素Logistic回归分析显示,PAR-1、PAR-2是影响HSCR患儿预后不良的独立危险因素(P<0.05).[结论]PAR-1、PAR-2在HSCR组织中呈高表达,与Krickenbeck评分呈负相关,是影响HSCR患儿预后不良的危险因素.

【Objective】To investigate the expression of protease activated receptor-1(PAR-1)and protease activated receptor-2(PAR-2)in Hirschsprung's disease(HSCR)and their relationship with prognosis.【Methods】A total of 100 children with HSCR who received radical surgery in our hospital from January 2014 to January 2019 were selected,and tissue samples of HSCR lesions(spastic segments)and normal intestinal mucosa adjacent to the lesions(more than 2 cm from the lesions)were taken.Immunohistochemistry was used to detect the expression of PAR-1 and PAR-2 in HSCR pathological tissue samples and normal intestinal mucosa tissues.Fluorescent quantitative PCR was used to detect the expression of PAR-1 mRNA and PAR-2 mRNA.Pearson's method was used to analyze the horizontal correlation between PAR-1,PAR-2,Krickenbeck scores,serum IL-6 and TNF-α.Logistic multivariate analysis was used to analyze the risk factors of poor prognosis in children with HSCR.【Results】The positive expression rates of PAR-1 and PAR-2 in the pathological tissues were higher than those in the adjacent tissues(P<0.05).Compared with the adjacent tissues,the expression levels of PAR-1 mRNA,PAR-2 mRNA and PAR-1,PAR-2 protein in the diseased tissues were significantly higher(P<0.05);The level of PAR-1,PAR-2 and serum IL-6,TNF-αin children in the poor prognosis group was significantly higher than that of the good prognosis group and the better prognosis group(P<0.05).The good prognosis group was higher than the better prognosis group(P<0.05).Pearson's results showed that PAR-1,PAR-2 were negatively correlated with Krickenbeck's score(P<0.05),and were positively correlated with IL-6 and TNF-α(mean P<0.05).Multivariate logistic regression analysis showed that PAR-1 and PAR-2 were independent risk factors for poor prognosis of children with HSCR(P<0.05).【Conclusion】PAR-1 and PAR-2 are highly expressed in HSCR tissues and negatively correlated with Krickenbeck score,which are risk factors for poor prognosis of children with HSCR.