子宫内膜癌组织CTGF、TWIST1、NCAPH的表达与临床病理特征及预后的关系

Relationship between expression of CTGF,TWIST1,NCAPH and clinicopathological features and prognosis in endometrial carcinoma

目的 探讨子宫内膜癌组织中结缔组织生长因子(CTGF)、TWIST1和非平滑肌细胞凝聚素Ⅰ复合亚单位H(NCAPH)蛋白的表达,以及与肿瘤临床病理特征及患者预后的关系。方法 回顾性分析2017年1月至2019年1月于南通大学附属海安医院行全子宫切除术140例患者的临床资料,其中术后病理证实为子宫内膜癌68例(子宫内膜癌组)、不典型增生42例(不典型增生组)和正常子宫内膜30例(正常组)。采用免疫组化染色法检测3组CTGF、TWIST1和NCAPH蛋白的阳性表达率,分析其与子宫内膜癌患者的肿瘤病理特征和预后的关系。结果 子宫内膜癌组CTGF、TWIST1和NCAPH蛋白的阳性表达率均明显高于不典型增生组和正常组,差异有统计学意义(P<0.05),而不典型增生组和正常组上述指标比较差异无统计学意义(P>0.05)。子宫内膜癌组CTGF、TWIST1和NCAPH蛋白的阳性表达率与患者年龄、肿瘤分化程度和病理类型无相关性(P>0.05),而与肿瘤临床分期、淋巴结转移和肿瘤肌层浸润深度密切相关(P<0.05)。Kaplan-Meier生存分析显示,子宫内膜癌组CTGF、TWIST1和NCAPH阳性表达患者的累积总生存率均明显低于阴性表达患者(P<0.05)。单因素和多因素COX回归分析显示,国际妇产科联盟(FIGO)分期Ⅲ~Ⅳ期、淋巴结转移阳性、CTGF、TWIST1和NCAPH阳性表达是患者死亡的独立危险因素(P<0.05)。结论 子宫内膜癌患者组织CTGF、TWIST1和NCAPH表达上调可能与肿瘤发生和发展密切相关,三者可作为预测生存预后的重要生物标志物。

Objective To investigate the relationship between expressions of tissue connective tissue growth factor(CTGF),TWIST1,non-SMC condensinⅠcomplex subunit H(NCAPH)proteins and clinicopathological features and prognosis in endometrial carcinoma.Methods Clinical data of totally 140 patients who underwent total hysterectomy in Hai′an Hospital Affiliated to Nantong University from January 2017 to January 2019 were retrospectively analyzed.Among them,68 cases of endometrial cancer(endometrial carcinoma group),42 cases of atypical hyperplasia(atypical hyperplasia group),and 30 cases of normal endometrial(normal group)were pathologically confirmed by postoperative pathology.Immunohistochemical staining was used to detect the positive expression rates of CTGF,TWIST1 and NCAPH proteins in the three groups.The relationships between the positive expression rates of those proteins and tumor pathological features,survival prognosis of endometrial carcinoma patients were analyzed.Results The positive expression rates of CTGF,TWIST1 and NCAPH proteins in endometrial carcinoma group were significantly higher than those in atypical hyperplasia group and normal group,with statistical significance(P<0.05),while there was no statistical significance between atypical hyperplasia group and normal group(P>0.05).The positive expressions of CTGF,TWIST1 and NCAPH proteins in endometrial carcinoma group were not correlated with patient age,tumor differentiation degree and pathological type(P>0.05),but were closely correlated with tumor clinical stage,lymph node metastasis and depth of myographic invasion(P<0.05).Kaplan-Meier survival analysis showed that the cumulative overall survival rate of patients with positive expression of CTGF,TWIST1 and NCAPH in endometrial carcinoma group was significantly lower than that of patients with negative expression(P<0.05).Univariate and multivariate COX regression analysis showed that International Federation of Obstetrics and Gynecology(FIGO)stagingⅢtoⅣ,positive lymph node metastasis,CTGF,TWIST1 and NCAPH were independent risk factors for death(P<0.05).Conclusion Upregulation of CTGF,TWIST1 and NCAPH in endometrial cancer may be closely related to tumor occurrence and development,and the indicators can be used as important biomarkers to predict survival and prognosis.