皮肤鳞状细胞癌组织Sirt3、DAB2IP表达与病理特征相关性及对术后复发的预测意义

Correlation between Sirt3 and DAB2IP Expression and Pathological Features in Cutaneous Squamous Cell Carcinoma and Their Significance in Predicting Postoperative Recurrence

目的分析皮肤鳞状细胞癌(cSCC)组织沉默信息调节因子3(Sirt3)、DOC2/DAB2相互作用蛋白(DAB2IP)表达与病理特征的关系,并分析二者对术后复发的预测价值。方法选取2018年7月—2020年6月本院cSCC患者193例,均行扩大切除病灶手术。观察cSCC患者肿瘤组织与癌旁组织Sirt3、DAB2IP表达情况,统计术后复发情况并比较术后复发与未复发cSCC患者的相关资料,采用Logistic回归分析cSCC患者术后复发的影响因素,采用受试者工作特征(ROC)曲线分析Sirt3、DAB2IP预测cSCC患者术后复发的价值,绘制Sirt3、DAB2IP预测cSCC患者术后复发的决策曲线并进行分析,不同Sirt3、DAB2IP表达的cSCC患者术后复发情况。结果cSCC患者肿瘤组织Sirt3、DAB2IP高表达例数多于低表达,差异有统计学意义(P<0.05);193例患者术后复发42例,未复发151例,术后复发的cSCC患者病灶直径、分化程度、术后切缘阳性、Sirt3及DAB2IP表达情况与未复发患者比较,差异有统计学意义(P<0.05);分化程度为低分化、术后切缘阳性Sirt3及DAB2IP高表达是cSCC患者术后复发的独立危险因素(P<0.05);Sirt3、DAB2IP联合检测预测cSCC患者术后复发的曲线下面积(AUC)值为0.669,高于二者单独检测;决策曲线分析显示,当风险阈值为0.20~0.45时,Sirt3、DAB2IP联合检测的净受益率大于单独检测;Sirt3+/DAB2IP+的cSCC患者术后复发率明显高于Sirt3+/DAB2IP-、Sirt3-/DAB2IP+及Sirt3-/DAB2IP-的患者(P<0.05)。结论cSCC组织中Sirt3、DAB2IP均呈高表达,二者同时高表达表明患者术后复发风险较高,可通过检测二者表达情况为临床早期筛查提供依据。

Objective In order to analyze the relationship between tissue silencing information regulator 3(Sirt3)and DOC2/DAB2 interaction protein(DAB2IP)expression and pathological features in cutaneous squamous cell carcinoma(cSCC),and to analyze the predictive value of both for postoperative recurrence.Methods A total of 193 patients with cSCC in our hospital from July 2018 to June 2020 were selected,who underwent extended excisional lesion surgery.The expression of Sirt3 and DAB2IP in tumor tissues and paraneoplastic tissues of cSCC patients was compared,the postoperative recurrence was counted and the relevant information of postoperative recurrence and non-recurrence cSCC patients was compared.The influence factors of postoperative recurrence in cSCC patients were analyzed by logistic regression,and the Sirt3 and DAB2IP prediction of cSCC patients was analyzed by receiver operator characteristic(ROC)curve.The value of postoperative recurrence,the decision curve of Sirt3 and DAB2IP predicting postoperative recurrence in cSCC patients,and postoperative recurrence in cSCC patients with different Sirt3 and DAB2IP expression were analyzed.Results The number of cSCC patients with high expression of Sirt3 and DAB2IP in tumor tissue was higher than that with low expression(P<0.05);42 patients recurred after surgery and 151 patients were cured completely.The diameter of lesions,degree of differentiation,positive postoperative margins,and expression of Sirt3 and DAB2IP in cSCC patients with recurrence after surgery were significantly different from those without recurrence(P<0.05).The degree of differentiation was hypodifferentiation,postoperative cut-off positive Sirt3 and high expression of DAB2IP were independent risk factors for postoperative recurrence in cSCC patients(P<0.05).The area under the curve(AUC)value of the combined Sirt3 and DAB2IP test for predicting postoperative recurrence in cSCC patients was 0.669,which was higher than the two tests alone;decision curve analysis showed that when the risk threshold was 0.20 to 0.45,the net benefit rate of combined Sirt3 and DAB2IP testing was greater than that of testing alone;the postoperative recurrence rate was significantly higher in cSCC patients with Sirt3+/DAB2IP+than in Sirt3+/DAB2IP-,Sirt3-/DAB2IP+,and Sirt3-/DAB2IP-patients(P<0.05).Conclusion The high expression of both Sirt3 and DAB2IP in cSCC tissues indicates that patients are at high risk of postoperative recurrence,and their expression can be detected to provide a basis for early clinical screening.