CDX2在十二指肠癌组织中的表达及其与预后的关系

Expression of CDX2 in duodenal carcinoma tissues and its relationship with prognosis

目的:观察尾侧型同源转录因子2(CDX2)在十二指肠癌组织中的表达及其与预后的关系。方法:收集2008年9月至2019年12月经病理组织学确诊的31例十二指肠癌根治术后患者的临床资料和病理组织切片。应用免疫组化检测CDX2在十二指肠癌中的表达。应用Kaplan-Meier法及Log-rank检验行生存分析。应用Cox风险比例回归模型行多因素分析。结果:十二指肠癌组织内CDX2的阳性率为51.6%(16/31)。CDX2的表达与TNM分期有关。分期越晚,CDX2阳性的表达率越低(P=0.016)。性别、年龄、分化程度、脉管癌栓、神经侵犯及胰腺侵犯均与CDX2的表达无关(P>0.05)。单因素分析显示,TNM分期、分化程度及CDX2表达均与十二指肠癌的预后相关。TNM分期越晚,生存率越低(P=0.01);中高分化者的生存率优于低分化者(P=0.005);CDX2阳性者的生存率优于阴性者(P=0.002)。性别、年龄、脉管癌栓、神经侵犯及胰腺侵犯均与预后无关(P>0.05)。多因素分析显示,分化程度(RR=0.258,95%CI:0.072~0.934,P=0.039)和CDX2的表达(RR=0.265,95%CI:0.079~0.890,P=0.032)是影响十二指肠癌的独立预后因素。结论:分化程度和CDX2是影响十二指肠癌患者的独立的预后因素,中高分化者的生存优于低分化者,CDX2阳性表达的患者生存优于CDX2阴性者。

Objective:To investigate the expression of caudal homologous transcription factor 2(CDX2)in duodenal carcinoma and its relationship with prognosis.Methods:Clinical data and pathological sections of 31 patients with duodenal carcinoma after radical surgery confirmed by histopathology from September 2008 to December 2019 were collected.The expression of CDX2 was detected by immunohistochemistry.Kaplan-Meier method and Log-rank test were used for survival analysis.Cox proportional regression model was used for multivariate analysis.Results:The positive rate of CDX2 in duodenal carcinoma was 51.6%(16/31).The expression of CDX2 was related to TNM stage.The later the stage,the lower the CDX2 positive expression rate(P=0.016).Gender,age,differentiation,vascular thrombus,nerve invasion and pancreatic invasion were not correlated with CDX2 expression(P>0.05).Univariate analysis showed that TNM stage,differentiation and CDX2 expression were correlated with the prognosis of duodenal carcinoma.The later TNM stage was,the lower the survival rate was(P=0.01).The survival rate of those with high differentiation was better than that of those with low differentiation(P=0.005).The survival rate of CDX2 positive patients was better than that of negative patients(P=0.002).Gender,age,vascular thrombus,nerve invasion and pancreatic invasion were not associated with prognosis(P>0.05).Multivariate analysis showed that differentiation(RR=0.258,95%CI:0.072~0.934,P=0.039)and CDX2 expression(RR=0.265,95%CI:0.079~0.890,P = 0. 032) were independent prognostic factors of duodenal carcinoma. Conclusion: Differentiationand CDX2 expressionare independent prognostic factors affecting duodenal carcinoma patients. The survival of patients with high differentiationis better than that of patients with low differentiation, and the survival of patients with positive CDX2 expressionis better than that of patients with negative CDX2 expression.