PPARγ/δ表达水平与结直肠癌病理参数及短期预后的关联研究

Correlation between PPARγ/δexpression level and pathological parameters and short⁃term prognosis of colorectal cancer

目的探讨过氧化物酶体增殖物活化受体(PPAR)γ/δ表达水平与结直肠癌病理参数与短期预后的关联。方法选取2019年2月至2021年2月新疆医科大学第六附属医院收治的118例结直肠癌患者,均经病理确诊。采用免疫组化SP法检测结肠癌组织PPARγ/δ表达水平,并收集患者临床资料,分析PPARγ/δ表达水平与结直肠癌病理参数的关系。治疗后随访3年,根据预后情况将其分为预后良好组、预后不良组,单因素筛选可能影响结直肠癌患者预后的因素,Logistic多因素回归分析法明确影响结直肠癌预后的危险因素,Kaplan⁃Meier法评估PPARγ/δ与结直肠癌患者短期预后的关系。结果结直肠癌组织中PPARγ/δ在不同的组织分化程度、浸润深度、淋巴结转移、TNM分期情况下表达差异有统计学意义(P<0.05)。随访结果显示,结直肠癌患者预后不良发生率约为40.68%(48/118),吸烟、肿瘤直径≥5 cm、低分化、浸润深度(T3~4)、淋巴结转移、PPARγ/δ高表达比例及纤维蛋白原(Fbg)水平较高是预后不良的影响因素(P<0.05)。Logistic多因素回归结果显示,肿瘤直径≥5 cm、低分化、浸润深度(T3~4)、淋巴结转移、Fbg水平高、PPARγ/δ高表达是影响结直肠癌患者预后的独立危险因素。PPARγ高表达结直肠癌患者术后3年无复发生存率47.50%低于PPARγ低表达结直肠癌患者的84.2%(Long Rank=14.692,P<0.05),PPARδ高表达结直肠癌患者术后3年无复发生存率45.90%低于PPARδ低表达结直肠癌患者的81.80%(Long Rank=13.915,P<0.05)。结论PPARγ/δ表达水平与结直肠癌患者病理参数、短期预后密切相关,有望成为预测结直肠癌患者预后的生物标志物。

Objective To investigate the relationship between peroxisome proliferator⁃activated receptor(PPAR)γ/δexpression level and pathological parameters and short⁃term prognosis of colorectal cancer.Methods A total of 118 patients with colorectal cancer admitted to The Sixth Affiliated Hospital of Xinjiang Medical University from February 2019 to February 2021 were selected,all of whom were confirmed by pathology.Immunohistochemical SP method was used to detect the expression levels of PPARγ/δin colon cancer tissues,and clinical data of patients were collected to analyze the relationship between the expression levels of PPARγ/δand pathological parameters of colorectal cancer.Patients were followed up for 3 years after treatment and were divided into good prognosis group and poor prognosis group.The factors that may affect the prognosis of patients with colorectal cancer were screened by single factor,and the risk factors affecting the prognosis of colorectal cancer were identified by Logistic multivariate regression analysis.Kaplan⁃Meier method was used to evaluate the relationship between PPARγ/δand short⁃term prognosis in patients with colorectal cancer.Results The expressions of PPARγand PPARδin colorectal cancer tissues were significantly different in different degrees of tissue differentiation,depth of invasion,lymph node metastasis and TNM stage(P<0.05).Follow⁃up results showed that the incidence of poor prognosis in colorectal cancer patients was about 40.68%(48/118),compared with the good prognosis group,In the poor prognosis group,smoking,tumor diameter≥5 cm,low differentiation,depth of invasion(T3⁃4),lymph node metastasis,high expression of PPARγ,high expression proportion of PPARδand high fibrinogen(Fbg)level were higher(P<0.05).Logistic multivariate regression results showed that tumor diameter≥5 cm,low differentiation,depth of invasion(T3⁃4),lymph node metastasis,high Fbg level,high expression of PPARγ,and high expression of PPARδwere independent risk factors affecting the prognosis of patients with colorectal cancer.The three⁃year relapse⁃free survival rate of patients with high PPARγexpression was 47.50%,which is lower than that of patients with low PPARγexpression(84.2%)(Long Rank=14.692,P<0.05).The 3⁃year recurrence⁃free survival rate of patients with high PPARδexpression was 45.90%,which id lower than that of patients with low PPARδexpression(81.80%)(Long Rank=13.915,P<0.05).Conclusions PPARγ/δexpression level is closely related to pathological parameters and short⁃term prognosis of colorectal cancer,and it is expected to be a biomarker for predicting prognosis of colorectal cancer patients.