子宫内膜癌病灶超声造影参数与Beclin1、Bax及CDK4表达水平的相关性分析

Correlation analysis of contrast-enhanced ultrasound parameters with Beclin1,Bax and CDK4 expression levels in endometrial cancer lesions*

目的分析子宫内膜癌病灶超声造影参数与Beclin1、Beclin1关联X蛋白(Bax)及周期素依赖性激酶4(CDK4)表达水平的相关性。方法选取2022年1月至2023年1月在联勤保障部队第九〇〇医院就诊的42例子宫内膜癌患者作为恶性组,58例癌前病变患者作为良性组。两组患者均给予超声造影成像检查并测定造影剂平均渡越时间(MMT)、达峰时间(TTP)及峰值强度(Peak),均进行子宫切除术并采集病灶组织,检测Beclin1、Bax、CDK4及周期素依赖性激酶6(CDK6)表达水平。采用Pearson相关分析子宫内膜癌病灶超声造影参数与Beclin1、Bax及CDK4表达水平的相关性。结果恶性组病灶Peak高于良性组,MMT长于良性组,TTP短于良性组,Beclin1、Bax表达水平低于良性组,CDK4、CDK6表达水平高于良性组,差异均有统计学意义(P<0.05)。恶性组中TNM分期为Ⅲ~Ⅳ期患者病灶Peak高于Ⅰ~Ⅱ期患者,MMT长于Ⅰ~Ⅱ期患者,TTP短于Ⅰ~Ⅱ期患者,差异均有统计学意义(P<0.05)。恶性组中TNM分期为Ⅲ~Ⅳ期患者病灶组织Beclin1、Bax表达水平低于Ⅰ~Ⅱ期患者,CDK4、CDK6表达水平高于Ⅰ~Ⅱ期患者,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,子宫内膜癌病灶Peak、MTT与CDK4及CDK6表达水平呈正相关(P<0.05),与Beclin1、Bax表达水平呈负相关(P<0.05),TTP与病灶组织CDK4及CDK6表达水平呈负相关(P<0.05),与Beclin1、Bax表达水平呈正相关(P<0.05)。结论子宫内膜癌患者MTT长于癌前病变患者,以及Peak、CDK4、CDK6表达水平均高于癌前病变患者,子宫内膜癌患者病灶超声造影参数MTT、TTP及Peak与Beclin1、Bax及CDK4表达水平相关,超声造影检查有助于辅助临床判断子宫内膜癌患者细胞凋亡相关蛋白表达情况。

Objective To analyze the correlation between contrast-enhanced ultrasound parameters and the expression levels of Beclin1,Beclin1-associated X protein(Bax)and cyclin dependent kinase 4(CDK4)in endometrial cancer lesions.Methods A total of 42 patients with endometrial cancer and 58 patients with precancerous lesions in the the 900th Hospital of the Joint Logistic Support Force from January 2022 to January 2023 were selected as the malignant group and the benign group.Contrast-enhanced ultrasound imaging was performed in both groups and the mean transit time(MMT),peak time(TTP)and peak intensity(Peak)of contrast agent were measured.Hysterectomy was performed in both groups and lesion tissues were collected to detect the expression levels of Beclin1,Bax,CDK4 and cyclin dependent kinase 6(CDK6).Pearson correlation was used to analyze the correlation between contrast-enhanced ultrasound parameters and the expression levels of Beclin1,Bax and CDK4 in endometrial cancer.Results The Peak of lesions in the malignant group was higher than that in the benign group,the MMT in the malignant group was longer than that in the benign group,the TTP in the malignant group was shorter than that in the benign group,the expression levels of Beclin1 and Bax were lower than those in the benign group,and the expression levels of CDK4 and CDK6 in the malignant group were higher than those in the benign group,with statistical significance(P<0.05).In the malignant group,the TNM stageⅢ-Ⅳpatients had a higher Peak than that ofⅠ-Ⅱpatients,the MMT ofⅢ-Ⅳpatients was longer than that ofⅠ-Ⅱpatients,and the TTP ofⅢ-Ⅳpatients was shorter than that ofⅠ-Ⅱpatients,and the differences were statistically significant(P<0.05).In malignant group,the expression levels of Beclin1 and Bax in lesion tissues of patients with TNM stageⅢ-Ⅳwere lower than those of patients with stageⅠ-Ⅱ,and the expression levels of CDK4 and CDK6 of patients with stageⅢ-Ⅳwere higher than those of patients with stageⅠ-Ⅱ,with statistical significance(P<0.05).Pearson correlation analysis showed that Peak and MTT in endometrial cancer lesions were positively correlated with the expression levels of CDK4 and CDK6(P<0.05)and negatively correlated with the expression levels of Beclin1 and Bax(P<0.05).TTP in endometrial cancer lesions was negatively correlated with the expression levels of CDK4 and CDK6(P<0.05)and positively correlated with the expression levels of Beclin1 and Bax(P<0.05).Conclusion MTT in patients with endometrial cancer was longer than that in patients with precancerous lesions,Peak,CDK4,CDK6 expression levels of focal contrast-enhanced in patients with endometrial cancer were higher than those in patients with precancerous lesions,and MTT,TTP and Peak of contrast-enhanced ultrasound parameters in patients with endometrial cancer were correlated with Beclin1,Bax and CDK4 expression levels.Contrast-enhanced ultrasound is helpful to evaluate the expression of apoptosis-related proteins in patients with endometrial carcinoma.