肾上腺嗜铬细胞瘤患者组织葡萄糖转运蛋白1和拓扑异构酶ⅡA表达与临床特征及预后的相关性分析

Analysis of the correlation between the expression of glucose transporter 1 and topoisomerase ⅡA in adrenal pheochromocytoma and clinical features and prognosis

目的探讨葡萄糖转运蛋白1(GLUT1)和拓扑异构酶ⅡA(TOP2A)在肾上腺嗜铬细胞瘤(PPGL)患者组织中的表达与临床特征及预后的相关性。方法选取2014年3月至2020年6月于新疆维吾尔自治区人民医院行手术切除的120例PPGL组织作为实验组。另收集同期行手术切除的100例无功能肾上腺腺瘤的肾上腺组织作为对照组。采用免疫组织化学染色法检测组织中GLUT1和TOP2A表达情况。通过Cox回归分析PPGL患者预后的影响因素。结果实验组中GLUT1的低表达率和TOP2A的高表达率均高于对照组[51.7%(62/120)比14.0%(14/100)、52.5%(63/120)比19.0%(19/100)],差异均有统计学意义(χ^(2)=34.225、31.829,均P<0.001)。GLUT1、TOP2A表达水平与镜下组织浸润和Ki-67有关(均P<0.05)。预后良好组中GLUT1高表达和TOP2A低表达比例均高于预后不良组,差异均有统计学意义(均P<0.001)。单因素分析结果显示,患者镜下组织浸润、Ki-67、GLUT1、TOP2A均是影响预后的因素(均P<0.001)。Cox多因素回归分析显示TOP2A、镜下组织浸润及Ki-67均是导致PPGL患者预后不良的危险因素,GLUT1为保护因素(均P<0.001)。结论GLUT1在PPGL组织中呈低表达,TOP2A呈高表达,与患者预后不良有关。

Objective To investigate the expression of glucose transporter 1(GLUT1)and topoisomeraseⅡA(TOP2A)in adrenal pheochromocytoma(PPGL)and their correlation with clinical features and prognosis.Methods A total of 120 cases of PPGL tissues that underwent surgical resection in Xinjiang Uygur Autonomous Region People′s Hospital from March 2014 to June 2020 were selected as the experimental group.The adrenal tissues of 100 cases of non-functional adrenal adenoma who underwent surgical resection during the same period were collected as control group.Immunohistochemical staining was used to detect the expression of GLUT1 and TOP2A in tissues.Cox regression was used to analyze the prognostic factors of PPGL patients.Results The low expression rate of GLUT1 and the high expression rate of TOP2A in the experimental group were higher than those in the control group[51.7%(62/120)vs 14.0%(14/100),52.5%(63/120)vs 19.0%(19/100)](χ^(2)=34.225,31.829,both P<0.001).The expression levels of GLUT1 and TOP2A were correlated with histological infiltration and Ki-67(both P<0.05).The proportions of GLUT1 high expression and TOP2A low expression in the good prognosis group were higher than those in the poor prognosis group(both P<0.001).Univariate analysis showed that histological infiltration,Ki-67,GLUT1 and TOP2A were prognostic factors(all P<0.001).Cox multivariate regression analysis showed that TOP2A,histological infiltration and Ki-67 were all risk factors for poor prognosis of PPGL patients,and GLUT1 was a protective factor(all P<0.001).Conlusion GLUT1 is low expression and TOP2A is high expression in PPGL tissues,which is related to poor prognosis of PPGL patients.