口腔鳞状细胞癌RECK 蛋白表达及临床意义

Expression and clinical significance of RECK protein in oral squamous cell carcinoma

目的检测口腔鳞状细胞癌(OSCC)组织RECK蛋白表达,探讨其表达和临床病理特征及预后的关系。方法回顾性收集2016年1月至2023年3月经防城港市第一人民医院收治的70例OSCC患者临床病历资料,采集肿瘤组织及30例正常口腔黏膜标本。采用免疫组织化学染色(IHC)法检测标本中RECK蛋白表达情况,分析其表达与OSCC临床病理特征的关系;采用单因素和多因素Cox回归分析影响患者总生存期(OS)的因素,采用Kaplan-Meier法绘制不同RECK表达患者的OS曲线。通过R语言绘制影响患者OS的预测列线图。结果OSCC组织中RECK高表达率为48.6%(34/70),显著低于正常组的86.7%(26/30),差异具有统计学意义(P<0.001)。RECK表达与TNM分期、分化程度、淋巴结转移有关(P<0.05);与性别、年龄无关(P>0.05)。TNM分期、分化程度、RECK表达是影响OS的独立预后因素(P=0.014、P=0.023、P=0.038);RECK低表达患者中位OS为25.5个月,差于高表达患者组(70个月,HR=2.07,95%CI:1.11~3.84,P=0.012)。根据多因素分析结果绘制的列线图具有较高的预测价值。结论RECK蛋白在OSCC组织中表达下调,可作为OSCC进展及预后的分子标志物。

Objective To detect the expression of RECK protein in oral squamous cell carcinoma(OSCC)and to investigate its relationship with clinicopathological features and prognosis.Methods Clinical data of 70 patients with OSCC admitted to Fangchenggang First People s Hospital from January 2016 to March 2023 were retrospectively collected.Tumor tissues and 30 normal oral mucosa specimens were collected.Immunohistochemical staining(IHC)was used to detect the expression of RECK protein in the samples,and the relationship between the expression and the clinicopathological features of OSCC was analyzed.Univariate and multifactor Cox regression analysis was used to analyze the factors affecting overall survival(OS)of patients,and Kaplan-Meier method was used to plot OS curves of patients with different RECK expression.The predictive nomogram that affects patients OS is drawn using R language.Results The overexpression rate of RECK in OSCC was 48.6%(34/70),significantly lower than that in normal group[86.7%(26/30)],and the difference was statistically significant(P<0.001).The expression of RECK was correlated with TNM stage,differentiation degree and lymph node metastasis(P<0.05).There was no correlation with gender or age(P>0.05).TNM stage,differentiation degree and RECK expression were independent prognostic factors of OS(P=0.014,P=0.023,P=0.038).The median OS of patients with low RECK expression was 25.5 months,which was worse than that of patients with high RECK expression(70 months,HR=2.07,95%CI:1.11-3.84,P=0.012).The column graph drawn based on the results of multi-factor analysis has high predictive value.Conclusion RECK protein is down-regulated in OSCC tissues and can be used as a molecular marker for the progression and prognosis of OSCC.