shh蛋白在前列腺癌中的表达及与临床预后的关系

The expression of shh protein in prostate cancer and its relationship with clinical prognosis

目的探讨shh蛋白在前列腺癌(PCa)中的表达及与临床预后的关系。方法选取2016年8月至2018年6月于邢台市第三医院接受治疗的82例PCa患者为研究组,选取同期88例良性前列腺增生(BPH)患者为对照组,采用免疫组化法检测前列腺组织中shh蛋白的表达情况。比较两组患者的shh蛋白表达水平,分析shh蛋白表达与PCa患者临床病理特征的关系,采用COX比例风险模型分析PCa预后的影响因素。将前列腺组织中shh蛋白阴性和弱阳性的PCa患者设为低表达组(36例),中等阳性和强阳性的PCa患者设为高表达组(46例),比较两组在3年生存情况。结果研究组的shh蛋白表达阳性率高于对照组(80.49%vs.50.00%,P<0.05)。shh蛋白表达阳性组的Gleason评分、前列腺特异性抗原(PSA)水平、T分期中T3~4期以及N分期中N1期的比例高于shh蛋白表达阴性组,差异均有统计学意义(均P<0.05)。随访3年,共28例(34.15%)患者死亡,COX比例风险模型分析显示Gleason评分(HR=1.669,95%CI:1.034~2.692)、T分期(HR=1.704,95%CI:1.122~2.587)、N分期(HR=1.968,95%CI:1.070~3.620)、shh蛋白(HR=1.885,95%CI:1.085~3.276)均是影响患者预后的独立危险因素(均P<0.05)。Log-rank分析结果显示,低表达组的3年存活率高于高表达组(P<0.05)。结论PCa癌组织中的shh蛋白高表达,且与PCa的发生、发展密切关联,是影响患者术后预后的危险因素,可作为评估术后预后的生物标志物。

Objective To investigate the expression of shh protein in prostate cancer(PCa)and its relationship with clinical prognosis.Methods From August 2016 to June 2018,a total of 82 patients with prostate cancer who received treatment in the Third Hospital of Xingtai City were selected as the study group and 88 patients with benign prostatic hyperplasia(BPH)during the same period were selected as the control group.The expression of shh protein in prostate tissue was detected by immunohistochemistry.The expression level of shh protein was compared between the two groups,and the relationship between shh protein expression and clinicopathological features of PCa patients was analyzed.COX proportional risk model was used to analyze the prognostic factors of prostate cancer.Results The positive rate of shh protein expression in PCa was higher than that in BPH(80.49%vs.50.00%,P<0.05).There were statistically significant differences in Gleason score,T stage,N stage and prostate-specific antigen(PSA)level between positive and negative shh protein expression groups(P<0.05),that is,Gleason score and PSA level were higher in positive group,and the proportion of T3 to 4 in T stage and N1 in N stage were higher.After 3 years of follow-up,28 patients(34.15%)died.COX proportional hazard model analysis showed Gleason score(HR=1.669,95%CI:1.034-2.692),T stage(HR=1.704,95%CI:1.22-2.587),N stage(HR=1.968,95%CI:1.070-3.620),shh protein(HR=1.885,95%CI:1.085-3.276)were independent risk factors affecting prognosis of patients(all P<0.05).In PCa patients with high shh protein expression,26 cases(56.52%)survived and 20 cases(48.48%)died.Log-rank analysis showed that the survival rate of the low expression group was higher than that of the high expression positive group(P<0.05).Conclusions shh protein is highly expressed in PCa and is closely related to the occurrence and development of PCa.It is a risk factor affecting the postoperative prognosis of patients and can be used as a biomarker to evaluate the postoperative prognosis.