胆管癌患者微量金属质量分数与肿瘤进展的关系

Relationship between trace metal levels and tumor progression in patients with cholangiocarcinoma

目的探讨微量金属在胆管癌患者肿瘤组织与肿瘤旁组织中的分布差异,分析微量金属质量分数与肿瘤分化程度和淋巴结转移的关系,为胆管癌的靶向治疗提供依据。方法选择兰州大学第一医院2012年1月—2015年12月通过病理学检测诊断为胆管癌的住院患者为研究对象,术中收集配对肿瘤组织和肿瘤旁健康组织,使用电感耦合等离子体质谱仪分析Cd、Co、Fe、Mn、Ni、Pb、Se、Zn 8种微量金属质量分数。采用Logistic回归和贝叶斯核机器回归模型探讨微量金属质量分数与胆管癌肿瘤分化程度和淋巴结转移的关系。结果肿瘤组织显示比肿瘤旁组织更低的Cd、Co、Fe、Ni质量分数(P<0.05)。发现肿瘤分化不良和淋巴结转移阳性的胆管癌患者拥有更低的Cd、Fe、Ni、Pb质量分数(P<0.05),并且肿瘤组织中Cd(OR=1.00,95%CI:[0.99,1.00])和Fe质量分数(OR=0.97,95%CI:[0.94,0.99])与胆管癌分化程度呈负相关关系(P<0.05)。贝叶斯核机器回归模型显示混合金属质量分数与胆管癌患者肿瘤分化程度和淋巴结转移呈显著负相关关系,且Cd、Ni是相关性最大的金属。结论微量金属质量分数的变化可能与胆管癌进展有关。

Objective To investigate the difference in the distribution of trace metals in tumor tissues and adjacent healthy tissues in patients with cholangiocarcinoma,and to analyze their relationship with the degree of tumor differentiation and lymph node metastasis,so as to provide evidence for targeted therapy of cholangiocarcinoma.Methods Inpatients admitted into The First Hospital of Lanzhou University from January 2012 to December 2015 and diagnosed with cholangiocarcinoma by pathological testing were selected as the study subjects,the paired tumors and adjacent healthy tissues were collected during surgery,and the levels of eight trace metals including Cd,Co,Fe,Mn,Ni,Pb,Se and Zn were analyzed by inductively coupled plasma mass spectrometry.Logistic regression and Bayesian kernel regression models were used to investigate the relationship between trace metals and the degree of tumor differentiation and lymph node metastasis of cholangiocarcinoma.Results The tumor tissue showed lower concentrations of Cd,Co,Fe and Ni than the control group(P<0.05).In addition,the study found that cholangiocarcinoma patients with poorly differentiated tumors and positive lymph node metastases had lower tissue levels of Cd,Fe,Ni,and Pb(P<0.05),and Cd(OR=1.00,95%CI:[0.99,1.00])and Fe concentration(OR=0.97,95%CI:[0.94,0.99])was negatively correlated with the differentiation degree of cholangiocarcinoma(P<0.05).The Bayesian kernel regression model showed that mixed metal levels were significantly negatively correlated with the degree of tumor differentiation and lymph node metastasis in patients with cholangiocarcinoma,and Cd and Ni were the most contributing metals.Conclusion The change of trace metal level may be related to the progression of cholangiocarcinoma,which could provide evidence for clinical treatment of patients with cholangiocarcinoma.