Tricellulin在结直肠癌组织中的表达及临床意义

Analysis of the expression level and clinical significance of the three-cell tight junction protein Tricellulin in colorectal cancer

目的:检测三细胞紧密连接蛋白Tricellulin在结直肠癌组织中的表达水平,分析其对临床病理特征和预后的影响。方法:收集2017年1月至2018年5月在我院接受根治性手术治疗的结直肠癌患者112例,采用免疫组化检测Tricellulin在结直肠癌组织中的表达。将患者分为细胞核中Tricellulin阳性细胞数<20组和细胞核中Tricellulin阳性细胞数≥20组。比较两组患者临床病理特征和术后3年生存率,Cox多因素回归分析影响患者预后的危险因素,受试者工作曲线分析分化程度、周围神经浸润、CEA和细胞核中Tricellulin表达阳性数对患者预后不良的预测价值。结果:细胞核中Tricellulin表达阳性数<20患者60例,阳性数≥20患者52例。细胞核中Tricellulin表达阳性数与患者年龄和性别无关(P>0.05),与T分期、N分期、分化程度、淋巴血管侵犯、周围神经浸润和CEA水平相关(P<0.05)。细胞核中Tricellulin表达阳性数≥20组术后3年生存率为59.6%(31/52),低于细胞核中Tricellulin表达阳性数<20组的80.0%(48/60)(log-rankχ^(2)=5.578,P=0.018)。低分化程度、周围神经浸润、CEA水平升高和细胞核中Tricellulin表达阳性数≥20为预后不良的危险因素。细胞核中Tricellulin表达阳性数≥20预测患者术后3年预后不良的曲线下面积为0.945(95%CI:0.927~0.958),灵敏度和特异度分别为89.4%、90.3%,临床预测价值高于分化程度、周围神经浸润和CEA水平(Z=5.320、5.715、4.032,P<0.05)。结论:细胞核中Tricellulin表达与结直肠癌分化程度和肿瘤分期有关,是患者术后预后不良的危险因素,具有较高的预测价值。

Objective:To detect the expression level of tricell tight junction protein Tricellulin in colorectal cancer tissues and analyze its influence on clinicopathological characteristics and prognosis.Methods:A total of 112 patients with colorectal cancer who underwent radical surgery in our hospital from January 2017 to May 2018 were collected.Immunohistochemistry was used to detect the expression of Tricellulin in colorectal cancer tissues,and the patients were divided into nuclei of Tricellulin.Less than 20 Tricellulin-positive cells in the nucleus groups and more than 20 Tricellulin-positive cells in the nucleus groups.To compare the clinicopathological characteristics and 3-year survival rate between the two groups of patients.The receiver operating curve analyzed the predictive value of the degree of differentiation,peripheral nerve infiltration,CEA and the positive number of Tricellulin expression in the nucleus on the poor prognosis of patients.Results:There were 60 patients with Tricellulin expression in the nucleus less than 20,and 52 patients with Tricellulin expression in the nucleus≥20.The positive number of Tricellulin expression in the nucleus was not related to the patient’s age and gender(P>0.05),but was related to T stage,N stage,degree of differentiation,lymphatic vascular invasion,peripheral nerve infiltration and CEA concentration(P<0.05).The positive number of Tricellulin expression in the nucleus≥20 group was 59.6%(31/52),which was lower than the positive number of Tricellulin expression in the nucleus<20 group 80.0%(48/60),log-rankχ^(2)=5.578,P=0.018.Poor differentiation,peripheral nerve infiltration,elevated CEA concentration,and Tricellulin expression in the nucleus≥20 were risk factors for poor prognosis,The positive number of Tricellulin expression in the nucleus≥20 predicts the poor prognosis area under the curve and the 95%CI were 0.945(0.927~0.958),the sensitivity and specificity were 89.4%and 90.3%,respectively.The clinical value of predicting poor prognosis at 3 years after surgery was higher than the degree of differentiation,peripheral nerve infiltration and CEA(Z=5.320,5.715,4.032,P<0.05).Conclusion:The expression of trillulin in the nucleus is related to the degree of differentiation of colorectal cancer and tumor analysis.It is a risk factor that affects the poor prognosis of patients and has a high predictive value for the poor prognosis of patients.