子宫内膜癌组织中S100A4蛋白表达情况与临床病理特征及预后的相关性分析

Correlation analysis of S100A4 protein expression with clinicopathological features and prognosis in endometrial carcinoma

目的分析子宫内膜癌(EC)组织中S100A4蛋白表达情况与临床病理特征及预后的相关性。方法收集中国人民解放军北部战区总医院2015年1月至2017年1月行手术治疗的60例EC患者的原发部位EC标本作为研究组,选取同时切除的癌旁5cm以上的正常子宫内膜组织作为对照组。采取免疫组化法检测两组所有标本中S100A4及细胞黏附分子(CAM)的表达,采用Spearman相关分析二者的相关性;分析研究组中S100A4表达情况与年龄、浸润肌壁深度、分化程度、国际妇产科联盟(FIGO)分期、淋巴结转移、脉管癌栓间的相关性;采用K-M法行生存分析、COX风险比例回归行预后影响因素分析探讨EC预后的相关因素。结果研究组S100A4及CAM阳性率(56.67%、53.33%)皆高于对照组(18.33%、20.00%),且二者在EC中呈正相关(r=0.504,P<0.001)。EC组织中S100A4阳性表达与年龄无关,与浸润肌壁深度、分化程度、FIGO分期、淋巴结转移情况、脉管癌栓有关(P<0.05)。K-M生存曲线显示,S100A4阳性和阴性患者的五年生存率分别为41.18%(14/34)、65.38%(17/26)。COX回归分析显示,S100A4是否阳性、浸润肌壁深度、分化程度、FIGO分期、淋巴结转移及脉管癌栓是生存率的影响因素,其中S100A4是否阳性是重要影响因素(P<0.05)。结论S100A4表达情况与EC多种临床病理特征相关,其高表达提示预后不良,可作为预测指标对EC患者进行预后评估,其可能成为EC的潜在治疗靶点。

Objective To analyze the correlation of S100A4 protein expression with clinicopathological features and prognosis in endometrial carcinoma(EC)tissues.Methods Primary site EC specimens of 60 patients with EC who underwent surgical treatment in the General Hospital of PLA Northern Theater Command from January 2015 to January 2017 were collected as the study group,and normal endometrial tissues of more than 5cm adjacent to cancer were selected as the control group.Immunohistochemistry was used to detect the expression of S100A4 and cell adhesion molecule(CAM),and Spearman correlation was used to analyze the correlation between the two groups.The association of S100A4 expression with age,depth of muscle wall invasion,degree of differentiation,international federation of gynecology and obstetrics(FIGO)staging,lymph node metastasis,and vascular cancer thrombus was analyzed in the study group.The prognostic factors related to EC was investigated by survival analysis through K-M method and analysis of prognostic factors through COX proportional regression.Results The positive rates of S100A4 and CAM in the study group(56.67%,53.33%)were higher than those in the control group(18.33%,20.00%),and they were positively correlated in EC(r=0.504,P<0.001).Positive expression of S100A4 in EC tissues was not associated with age,but with the depth of muscle wall invasion,degree of differentiation,FIGO stage,lymph node metastasis,and vascular cancer thrombi(P<0.05).The K-M survival curve showed that the 5-year survival rates of S100A4 positive and negative patients were 41.18%(14/34)and 65.38%(17/26),respectively.COX regression analysis showed that positive S100A4,depth of muscle wall invasion,degree of differentiation,FIGO stage,lymph node metastasis and vascular cancer thrombi were the influencing factors for survival,and positive S100A4 was the important influencing factor(P<0.05).Conclusions The expression of S100A4 is associated with various clinicopathological features of EC,and its high expression indicates poor prognosis.It can be used as a predictor to evaluate the prognosis of EC patients,and may become a potential therapeutic target for EC.