胰腺导管腺癌患者KLK11的表达水平及患者生存的影响因素分析

Analysis of KLK11 Expression Level and Influencing Factors of Survival in Patients with Pancreatic Ductal Adenocarcinoma

目的:探讨胰腺导管腺癌患者肿瘤组织中组织激肽释放酶11(KLK11)的表达水平及临床意义。方法:选取2018年1月—2022年12月在宜昌市中心人民医院接受根治性胰十二指肠切除术的152例胰腺导管腺癌患者,收集所有纳入患者的临床资料,分析KLK11低表达(n=65)和高表达(n=87)的免疫组化结果及其对患者生存的影响,并进一步通过Cox比例风险模型进行单因素和多因素分析探讨影响胰腺导管腺癌患者生存的独立影响因素。结果:免疫组化结果显示,胰腺导管腺癌组织中存在KLK11低表达及高表达;KLK11高表达组患者的生存率明显低于KLK11低表达组患者(P=0.003);肿瘤中-低分化(HR=3.447,95%CI:1.542,7.707)、肿瘤>3.0 cm(HR=4.452,95%CI:2.094,9.465)、TNM分期为Ⅱ期(HR=14.840,95%CI:5.284,41.680)/Ⅲ期(HR=27.880,95%CI:9.419,82.550)、有门静脉侵犯(HR=4.929,95%CI:1.395,17.421)及KLK11高表达(HR=6.007,95%CI:2.270,15.895)均是影响胰腺导管腺癌患者术后生存的独立危险因素(均P<0.05)。结论:肿瘤中-低分化、肿瘤>3.0 cm、TNM分期为Ⅱ期/Ⅲ期、有门静脉侵犯及KLK11高表达是影响胰腺导管腺癌患者术后生存的独立危险因素。

Objective:To investigate the expression level and clinical significance of kallikrein 11(KLK11)in tumor tissue of patients with pancreatic ductal adenocarcinoma.Methods:A total of 152 patients with pancreatic ductal adenocarcinoma who underwent radical pancreatoduodenectomy at Yichang Central People's Hospital from January 2018 to December 2022 were selected.The clinical data of all included patients were collected,and the immunohistochemical results of low expression(n=65)and high expression(n=87)of KLK11 were analyzed,as well as their impact on the survival of patients.Furthermore,univariate and multivariate analyses were conducted using the Cox proportional hazards model to explore the independent influencing factors affecting the survival of patients with pancreatic ductal adenocarcinoma.Results:Immunohistochemical results showed that there were low and high expressions of KLK11 in pancreatic ductal adenocarcinoma tissues.The survival rate of patients with high KLK11 expression was significantly lower than that of patients with low KLK11 expression(P=0.003).Moderate-to-poor tumor differentiation(HR=3.447,95%CI:1.542,7.707),tumor size>3.0 cm(HR=4.452,95%CI:2.094,9.465),TNM stageⅡ(HR=14.840,95%CI:5.284,41.680)/Ⅲ(HR=27.880,95%CI:9.419,82.550),portal vein invasion(HR=4.929,95%CI:1.395,17.421),and high KLK11 expression(HR=6.007,95%CI:2.270,15.895)were independent risk factors affecting the survival of patients with pancreatic ductal adenocarcinoma after surgery(all P<0.05).Conclusion:Moderate-to-poor tumor differentiation,tumor size>3.0 cm,TNM stageⅡ/Ⅲ,portal vein invasion,and high KLK11 expression are independent risk factors affecting the survival of patients with pancreatic ductal adenocarcinoma after surgery.