脑胶质瘤组织中APP蛋白高表达对术后放疗的影响

Effect of high expression of APP proteina on postoperative radiotherapy in patients with brain gliom

目的探讨分析脑胶质瘤组织中淀粉样前体蛋白(amyloid precursorproteinAPP)高表达对患者术后放疗的影响。方法回顾性分析2020年2月至2022年2月济宁医学院附属医院肿瘤科收治96例手术切除的脑胶质瘤患者,男57例,女39例;年龄(56.45±4.32)岁,范围28~79岁。收集患者性别、年龄、肿瘤位置、病灶个数、手术切除、整体肿瘤减负率、放疗剂量、术前KPS评分最大病灶直径、Ki67增殖指数等临床病理资料,取其脑胶质瘤组织标本96份。根据术后放疗效果将患者分为放疗效果良好组54例和放疗效果不良组42例,采用Westernblot法检测低级别脑胶质瘤(52例)和高级别脑胶质瘤组织(44例)中APP表达水平,采用单因素分析放疗效果良好组和放疗效果不良组临床病理资料,找出影响脑胶质瘤患者术后放疗的影响因素,采用多因素Logistic分析APP蛋白表达与脑胶质瘤术后放疗的关系。结果96例脑胶质瘤患者,APP蛋白高表达56(58.33%)例。高级别脑胶质瘤APP蛋白高表达率高于低级别脑胶质瘤(X=6.92,P<0.05)。96例脑胶质瘤患者术后放疗效果评价结果显示,完全缓解21例(21.88%),部分缓解33例(34.38%),稳定26例(27.08%),进展16例(16.67%),客观缓解率56.25%(54/96)。单因素分析显示,放疗效果不良组高级别脑胶质瘤、最大病灶直径≥6cm、Ki67增殖指数≥10%、APP蛋白高表达占比高于放疗效果良好组(x^(2)=6.96、9.42、24.28、37.48,P<0.05)。多因素Logistic回归分析,病理级别高级别脑胶质瘤(0R=2.838,95%CI:1.501~5.366)、APP蛋白高表达(0R=3.089,95%CI:1.364~6.996)是影响脑胶质瘤患者术后放疗效果的独立危险因素(P<0.05)。结论脑胶质瘤组织中APP蛋白呈较高表达,其表达随脑胶质瘤病理级别的增加而升高,APP蛋白高表达是影响脑胶质瘤患者术后放疗效果不良的独立危险因素。

Objective To explore and analyze the influence of amyloid precursor protein(APP)protein high expression in brain glioma tissue on postoperative radiotherapy.Methods Retrospective analysis was per-formed on 96 patients with surgically resected glioma admitted to the Department of Oncology,Affiliated Hospital of Jining Medical College from Feb.2020 to Feb.2022.Clinicopathologic data such as gender,age,tumor location,number of lesions,surgical resection,overall tumor burden reduction rate,radiotherapy dose,maximum lesion di-ameter of preoperative KPS score and Ki-67 proliferation index were collected,and 96 brain glioma tissue samples were collected.According to the effect of postoperative radiotherapy,the patients were divided into a good radiother-apy effect group(54 cases)and a poor radiotherapy effect group(42 cases),and the number location,size,patho-logical grade and other clinical data of the two groups were compared.The expression level of APP in low-grade gli-oma(52 cases)and high-grade glioma tissue(44 cases)was detected by Western blot method.The clinicopatho-logic data of patients in the group with good radiotherapy effect and the group with poor radiotherapy effect were an-alyzed by single factor tofind out the influencing factors of postoperative radiotherapy for patients with glioma.Mul-tivariate Logistic analysis was used to analyze the relationship between APP protein expression and postoperative radiotherapy for glioma.ResultsAmong the 96 brain glioma patients,56 cases had high expression of APP pro-tein,with high expression rate of 58.33%.The high expression rate of APP protein in high grade gliomas was higher than that in low grade gliomas(x^(2)=6.924,P<0.05).Evaluation results of postoperative radiotherapy for 96 glioma patients showed complete remission was in 21 cases(21.88%),partial remission in 33 cases(34.38%),stable in 26 cases(27.08%)and progressive in 16 cases(16.67%),with an objective remission rate of 56.25%(54/96).Univariate analysis showed that the proportion of high grade glioma,maximum lesion diameter≥6 cm,Ki67 proliferation index≥10%and high expression of APP protein in the poor radiotherapy effect group was higher than that in the good radiotherapy effect group(x^(2)=6.959,9.423,24.282,37.481,P<0.05).Multivariate Logistic regression analysis showed that the pathological grade of high-grade glioma(OR=2.838,95%CI:1.501-5.366)and high expression of APP protein(OR=3.089,95%CI:1.364-6.996)were independent risk factors for the effect of postoperative radiotherapy in patients with glioma(P<0.05).Conclusions APP protein is highly expressed in glioma tissues,and its expression increases with the increase of the pathological grade of glioma.APP protein high expression is an independent risk factor affecting the adverse effect of postoperative radiotherapy in glioma patients.