细胞骨架相关蛋白4在肾透明细胞癌中的表达及其临床意义

Expression of cytoskeleton⁃associated protein 4 in clear cell renal cell carcinoma and its clinical significance

目的 探讨细胞骨架相关蛋白4(cytoskeleton-associated protein 4,CKAP4)在肾透明细胞癌(clear cell renal cell carcinoma,ccRCC)中的表达及其临床意义。方法 收集237例ccRCC患者的癌组织和癌旁组织,采用免疫组化法检测CKAP4蛋白的表达水平,采用χ^(2)检验比较不同CKAP4蛋白表达水平患者的临床病理特征,Kaplan-Meier法和Log-rank检验分析不同CKAP4表达水平患者总生存期(overall survival,OS)和无进展生存期(progression-free survival,PFS)的差异,Cox比例风险回归分析影响ccRCC患者术后OS和PFS的因素。结果 ccRCC组织中CKAP4蛋白的高表达率显著高于癌旁组织(54.0%vs 23.6%,χ^(2)=46.050,P<0.001)。Fuhrman分级高、肿瘤浸润深、有淋巴结转移、远处转移以及TNM分期高的ccRCC患者癌组织中CKAP4蛋白高表达(均P<0.05)。CKAP4蛋白高表达的ccRCC患者OS率(χ^(2)=6.394,P=0.011)和PFS率(χ^(2)=10.065,P=0.002)均较CKAP4蛋白低表达者显著降低。CKAP4蛋白高表达是影响ccRCC患者术后OS(HR=2.884,95%CI:1.425~4.765,P<0.001)和PFS(HR=3.512,95%CI:1.987~5.326,P<0.001)的独立危险因素。结论 CKAP4蛋白在ccRCC组织中呈高表达,且CKAP4蛋白高表达是ccRCC患者不良预后的独立危险因素。

Objective To investigate the expression of cytoskeleton‑associated protein 4(CKAP4)in clear cell renal cell carcinoma(ccRCC)and its clinical significance.Methods A total of 237 tumor tissues and paracancerous tissues were collected from ccRCC patients.The expression level of CKAP4 protein was detected by immunohistochemistry.The clinicopathological characteristics of ccRCC patients with different CKAP4 protein expression levels were compared byχ^(2) test.The Kaplan‑Meier method and Log‑rank test were used to analyze the differences in the overall survival(OS)and progression‑free survival(PFS)of patients with different CKAP4 protein expression levels.Cox proportional hazard regression was performed to analyze the influencing factors of OS and PFS in the patients with ccRCC.Results The high expression rate of CKAP4 protein in ccRCC tissues was significantly higher than that in paracancerous tissues(54.0%vs 23.6%,χ^(2)=46.050,P<0.001).CKAP4 protein was highly expressed in the cancer tissues of ccRCC patients with higher Fuhrman grade,deeper tumor invasion,lymph node metastasis,distant metastasis and higher TNM stage(all P<0.05).The ccRCC patients with high expression of CKAP4 protein had significantly lower OS rate(χ^(2)=6.394,P=0.011)and PFS rate(χ^(2)=10.065,P=0.002)than those with low CKAP4 protein expression.High expression of CKAP4 protein was an independent risk factor for postoperative OS(HR=2.884,95%CI:1.425-4.765,P<0.001)and PFS(HR=3.512,95%CI:1.987-5.326,P<0.001)in the patients with ccRCC.Conclusions CKAP4 protein is highly expressed in ccRCC tissues,and is an independent risk factor for poor prognosis in the patients with ccRCC.