胰岛素样生长因子2-MRNA结合蛋白2与口腔黏膜黑色素瘤患者病理特征和预后的关系

The relationship between insulin-like growth factor 2 mRNA binding protein 2 and pathological characteristics and prognosis of oral mucosal melanoma patients

目的探讨胰岛素样生长因子2-MRNA结合蛋白2(IGF2BP2)表达变化及其与患者临床病理特征和预后的关系。方法选取驻马店市中心医院收治的口腔黏膜黑色素瘤患者75例,取病理检测的肿瘤组织和癌旁正常组织,采用免疫组织化学法检测IGF2BP2蛋白表达,分析肿瘤组织IGF2BP2蛋白表达与患者临床临床病理学的关系。随访3年,统计生存情况,分析肿瘤组织IGF2BP2蛋白表达水平与患者3年生存率的关系。计数资料比较采用卡方检验。结果癌旁组织IGF2BP2蛋白表达阳性率[17.33%(13/75)]明显低于口腔黏膜黑色素瘤组织[82.67%(62/75)],差异有统计学意义(χ^(2)=15.254,P<0.01)。男性患者IGF2BP2蛋白表达阳性率[82.35%(42/51)]与女性患者肿瘤组织[83.33%(20/24)]比较,差异无统计学意义(χ^(2)=0.574,P>0.05)。年龄≥40岁患者IGF2BP2蛋白表达阳性率[80.49%(33/41)]与女性患者肿瘤组织[82.35%(28/34)]比较,差异无统计学意义(χ^(2)=0.807,P>0.05)。肿瘤直径≥4 cm患者IGF2BP2蛋白表达阳性率[81.40%(35/43)]与肿瘤直径<4 cm患者肿瘤组织[84.38%(27/32)]比较,差异无统计学意义(χ^(2)=0.987,P>0.05)。发病于牙龈患者IGF2BP2蛋白表达阳性率[80.85%(38/47)]与女性患者肿瘤组织[85.71%(24/28)]比较,差异无统计学意义(χ^(2)=0.681,P>0.05)。Ⅰ~Ⅱ期患者IGF2BP2蛋白表达阳性率[76.19%(32/42)]低于Ⅲ~Ⅳ期患者肿瘤组织[90.91%(30/33)]比较,差异有统计学意义(χ^(2)=4.281,P<0.01)。未淋巴结转移患者IGF2BP2蛋白表达阳性率[70.27%(26/37)]与女性患者肿瘤组织[94.74%(36/38)]比较,差异有统计学意义(χ^(2)=8.991,P<0.01)。IGF2BP2低表达患者3年生存率[84.61%(11/13)]明显高于IGF2BP2高表达患者[54.84%(34/62)],差异有统计学意义(χ^(2)=12.984,P<0.01)。单因素回归分析结果显示临床分期、淋巴结转移和IGF2BP2表达水平与口腔黏膜黑色素瘤患者预后有关(r=0.254、0.514、0.198,P均<0.05)。多因素Cox回归模型结果显示IGF2BP2表达水平高表达是口腔黏膜黑色素瘤患者不良预后的危险因素(P<0.05)。结论口腔黏膜黑色素瘤组织中IGF2BP2蛋白高表达,与肿瘤临床分期和淋巴结转移等临床病理学特征和预后密切相关。

Objective To investigate the expression changes of insulin-like growth factor 2 mRNA binding protein 2(IGF2BP2)and its relationship with clinical pathological characteristics and prognosis of patients.Methods 75 patients with oral mucosal melanoma admitted to Zhumadian Central Hospital were selected.Pathological examination of tumor tissue and normal adjacent tissues was performed,and the expression of IGF2BP2 protein was detected using immunohistochemistry.The relationship between the expression of IGF2BP2 protein in tumor tissue and the clinical pathology of the patients was analyzed.Follow up for 3 years,collect survival data,and analyze the relationship between the expression level of IGF2BP2 protein in tumor tissue and the 3-year survival rate of patients.The comparison of count data is conducted using chi square test.Results The positive rate of IGF2BP2 protein expression in adjacent cancer tissues[17.33%(13/75)]was significantly lower than that in oral mucosal melanoma tissues[82.67%(62/75),χ^(2)=15.254,P<0.05].There was no statistically significant difference in the positive rate of IGF2BP2 protein expression between male patients[82.35%(42/51)]and female patients’tumor tissues[83.33%(20/24),χ^(2)=0.574,P>0.05].The positive rate of IGF2BP2 protein expression in patients aged≥40 years[80.49%(33/41)]was not statistically significant compared to the positive rate of IGF2BP2 protein expression in tumor tissue of female patients[82.35%(28/34),χ^(2)=0.807,P>0.05].The positive rate of IGF2BP2 protein expression in patients with tumor diameter≥4 cm[81.40%(35/43)]was not statistically significant compared to the positive rate of IGF2BP2 protein expression in tumor tissue of patients with tumor diameter<4 cm[84.38%(27/32),χ^(2)=0.987,P>0.05].The positive rate of IGF2BP2 protein expression in gingival patients[80.85%(38/47)]was not statistically significant compared to the positive rate of IGF2BP2 protein expression in tumor tissue of female patients[85.71%(24/28),χ^(2)=0.681,P>0.05].The positive rate of IGF2BP2 protein expression in stageⅠ-Ⅱpatients[76.19%(32/42)]was lower than that in tumor tissue of stageⅢ-Ⅳpatients[90.91%(30/33),χ^(2)=4.281,P<0.05].The positive rate of IGF2BP2 protein expression in patients without lymph node metastasis[70.27%(26/37)]was not statistically significant compared to the positive rate of IGF2BP2 protein expression in tumor tissue of female patients[94.74%(36/38),χ^(2)=8.991,P<0.05].The 3-year survival rate of patients with low expression of IGF2BP2[84.61%(11/13)]was significantly higher than that of patients with high expression of IGF2BP2[54.84%(34/62)],and the difference was statistically significant(χ^(2)=12.984,P<0.05).The results of univariate regression analysis showed that clinical staging,lymph node metastasis,and IGF2BP2 expression levels were associated with the prognosis of oral mucosal melanoma patients(P<0.05).The results of the multivariate Cox regression model showed that high expression levels of IGF2BP2 were a risk factor for poor prognosis in patients with oral mucosal melanoma(r=0.254,0.514,0.198,P<0.05).Conclusion The high expression of IGF2BP2 protein in oral mucosal melanoma tissue is closely related to clinical pathological features and prognosis such as tumor staging and lymph node metastasis.