摘要
目的 探讨肾细胞癌(RCC)患者癌组织中前B细胞白血病转录因子1(PBX1)、MEIS2表达水平与患者临床表现及预后的关系.方法 选取2017年5月至2020年5月本院收治的96例RCC患者作为研究对象,将手术获取的癌组织标本纳入RCC组(96例),将对应的癌旁组织标本纳入癌旁组(96例).采用免疫组化法检测组织中的PBX1、MEIS2表达情况.统计分析PBX1、MEIS2表达与RCC患者临床病理特征的关系;采用多因素Cox回归分析RCC患者预后的影响因素.结果 RCC组的PBX1、MEIS2阳性表达率均高于癌旁组[75.00％(72/96)vs.34.38％(33/96),71.88％(69/96)vs.40.63％(39/96),均 P＜0.001].RCC 分期为 Ⅲ 期、WHO/ISUP分级为3/4级、有淋巴结转移患者的PBX1阳性表达率、MEIS2阳性表达率均高于RCC分期为Ⅰ～Ⅱ期、WHO/ISUP分级为1/2级、无淋巴结转移的患者(均P＜0.05).RCC分期为Ⅰ/Ⅱ期、WHO/ISUP分级为1/2级、无淋巴结转移、PBX1阴性、MEIS2阴性患者的3年总生存率均高于RCC分期为Ⅲ期、WHO/ISUP分级为3/4级、淋巴结有转移、PBX1阳性、MEIS2阳性患者(均P＜0.05).多因素Cox回归分析显示,临床分期Ⅲ期(HR=2.389,95％CI:1.444～3.954)、PBX1(HR=3.699,95％CI:1.941～7.049)、MEIS2(HfR=4.145,95％CI:1.885～9.115)是RCC患者预后的影响因素(均P＜0.05).结论 PBX1、MEIS2在RCC患者癌组织中呈高表达,与RCC临床分期、分化程度等因素密切相关,可作为辅助评估患者预后的潜在标志物.
Abstract
Objective To explore the relationship between the expression levels of preB-cell leukemia transcription factor 1(PBX1)and MEIS2 and the clinical manifestations and prognosis of pa-tients with renal cell carcinoma(RCC).Methods Ninety-six patients with RCC treated in our hospi-tal from May 2017 to May 2020 were selected as the study objects.Cancer tissue specimens were included in the RCC group(96 cases),and corresponding paracancer tissue specimens were included in the para-cancer group(96 cases).The expression of PBX1 and MEIS2 in tissues was detected by immunohistochemical method.The relationship between the expression of PBX1 and MEIS2 and the clinicopathological features of RCC patients was analyzed.The prognostic factors of RCC patients were investigated by multivariate Cox regression analysis.Results The positive expression rates of PBX1 and MEIS2 in RCC group were higher than those in para-cancer group[75.00％(72/96)vs.34.38％(33/96),71.88％(69/96)vs.40.63％(39/96),allP＜0.001].The PBX1 positive expression rate and MEIS2 positive expression rate in patients with RCC stage Ⅲ,WHO/ISUP grade 3/4,and lymph node metastasis were higher than those with RCC stage Ⅰ/Ⅱ,WHO/ISUP grade 1/2,and no lymph node metastasis(all P＜0.05).The 3-year overall survival rate of patients with RCC stage Ⅰ/Ⅱ,WHO/ISUP grade 1/2,no lymph node metastasis,negative PBX1 and negative MEIS2 was higher than that of patients with RCC stage Ⅲ,WHO/ISUP grade 3/4,lymph node metastasis,positive PBX1 and positive MEIS2(all P＜0.05).Multivariate Cox regression analysis showed that the clini-cal stage Ⅲ(HR=2.389,95％CI:1.444-3.954),PBX1(HR=3.699,95％CI:1.941-7.049),MEIS2(HR=4.145,95％CI:1.885-9.115)were prognostic factors in RCC patients(all P＜0.05).Conclusions PBX1 and MEIS2 are highly expressed in the cancer tissues of RCC patients,which are closely related to the clinical stage and differentiation degree of RCC,and can be used as potential markers to assist in evaluating the prognosis of patients.
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