首页|肝内胆管癌组织中CircACTN4 mRNA和THBS1mRNA的表达与临床病理特征及预后的关系研究

肝内胆管癌组织中CircACTN4 mRNA和THBS1mRNA的表达与临床病理特征及预后的关系研究

Relationship between the Expression of CircACTN4 mRNA and THBS1mRNA in Intrahepatic Cholangiocarcinoma Tissue with Clinicopathological Features and Prognosis

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目的 研究肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)中环状核糖核酸辅肌动蛋白α4(CircRNAs Actinin α 4,Circ ACTN4)和血小板凝血酶蛋白1(platelet thrombin protein 1,THBS1)mRNA表达与临床病理特征和预后的关系,为临床诊治提供参考.方法 回顾性分析2017年5月~2020年6月西安交通大学第二附属医院诊治的84例ICC患者;采用实时荧光定量PCR及免疫组织化学检测组织中CircACTN4 mRNA,THBS1 mRNA和蛋白表达.Pearson相关分析 ICC 癌组织中 CircACTN4 mRNA 与 THBS1 mRNA 的相关性.Kaplan-Meier 法(Log-rank 检验)比较不同 CircACTN4 mRNA,THBS1 mRNA表达ICC患者预后差异.COX回归分析ICC患者预后影响因素.受试者工作特征(ROC)曲线分析CircACTN4mRNA,THBS1 mRNA对ICC患者死亡预后的评估价值.结果 ICC癌组织中CircACTN4mRNA(3.14±0.42)表达高于癌旁组织(0.76±0.25),差异具有统计学意义(t=4.094,P<0.001);ICC癌组织中THBS1 mRNA(2.82±0.36)和蛋白阳性率(92.86%)均高于癌旁组织(0.81±0.24,7.14%),差异具有统计学意义(t/x2=42.068,123.429,均P<0.001).ICC癌组织中CircACTN4 mRNA与THBS1mRNA表达呈正相关(r=0.669,P<0.001).TNM分期Ⅲ期、低分化程度及有淋巴结转移ICC癌组织中CircACTN4 mRNA,THBS1 mRNA表达高于TNM分期Ⅰ~Ⅱ期、高中分化程度及无淋巴结转移癌组织,差异具有统计学意义(x2=7.949,9.164,12.207;23.270,18.625,19.828,均 P<0.001).CircACTN4 mRNA高表达组、THBS1 mRNA高表达组三年累积生存率分别低于CircACTN4 mRNA低表达组(25.00%vs 56.82%)和THBS1 mRNA 低表达组(19.51%vs 62.79%),差异具有统计学意义(Log rankx2=13.601,24.310,均 P<0.001).CircACTN4 mRNA(OR=1.839,95%CI:1.228~2.753)、THBS1 mRNA(OR=1.744,95%CI:1.245~2.443)、淋巴结转移(OR=1.925,95%CI:1.316~2.816)、TNM 分期(OR=1.613,95%CI:1.223~2.126)及肿瘤分化程度(OR=1.510,95%CI:1.205~1.892)是影响ICC预后的独立因素(均P<0.01).CircACTN4 mRNA,THBS1 mRNA联合检测对ICC患者死亡预后的评估曲线下面积为0.868,大于单项指标检测0.812,0.784,差异具有统计学意义(Z=3.348,3.847,均P<0.001).结论 ICC中CircACTN4 mRNA和THBS1 mRNA表达升高,两者与TNM分期、分化程度及淋巴结转移相关,是新的评估ICC患者不良预后的肿瘤标志物.
Objective To investigate the expression of circular RNA(Circ RNAS)Actinin α 4(ACTN4)and platelet thrombin protein 1(THBS1)in intrahepatic cholangiocarcinoma(ICC)and their relationship with clinicopathological characteristics and prognosis,and provide reference for clinical diagnosis and treatment.Method A retrospective analysis was conducted on 84 ICC patients diagnosed and treated in the Second Affiliated Hospital of Xian Jiaotong University from May 2017 to June 2020.The expressions of CircACTN4 mRNA,THBS1 mRNA and protein were detected by real-time fluorescent quantitative PCR and immunohistochemistry.Pearson correlation analysis was used to analyze the correlation between CircACTN4 mRNA and THBS1 mRNA in ICC cancer tissue.The prognostic differences of ICC patients with different CircACTN4 mRNA and THBS1 mRNA expressions were compared by the Kaplan-Meier method(log rank test).COX regression analysis was performed to identify prognostic factors in ICC patients.The prognostic value of CircACTN4 mRNA and THBS1 mRNA in evaluating the risk of death in ICC patients was assessed by receiver operating characteristic(ROC)curve analysis.Results The expression of CircACTN4 mRNA in ICC tissues(3.14±0.42)was higher than that in adjacent tissues(0.76±0.25),with significant difference(t=44.094,P<0.001).The positive rates of THBS1 mRNA(2.82±0.36)and protein positive rate(92.86%)in ICC tissues were higher than those in adjacent tissues(0.81±0.24,7.14%),and the differences were statistically significant(t/x2=42.068,123.429,all P<0.001).CircACTN4 mRNA was positively correlated with THBS1 mRNA in ICC cancer tissue(r=0.669,P<0.001).The expressions of CircACTN4 mRNA,THBS1 mRNA in ICC cancer tissues with TNM stage Ⅲ,low differentiation,and lymph node metastasis were higher than those in TNM stage Ⅰ~Ⅱ,high differentiation,and non-lymph node metastasis cancer tissues,and the differences were statistically significant(x2=7.949,9.164,12.207;23.270,18.625,19.828,all P<0.001).The 3-year cumulative survival rates of the high expression group of CircACTN4 mRNA and THBS1 mRNA were lower than those of the low expression group of CircACTN4 mRNA(25.00%vs 56.82%)and THBS1 mRNA(19.51%vs 62.79%),and the differences were statistically significant(Log rank x2=13.601,24.310,all P<0.001).CircACTN4 mRNA(OR=1.839,95%CI:1.228~2.753),THBS1 mRNA(OR=1.744,95%CI:1.245~2.443),lymph node metastasis(OR=1.925,95%CI:1.316~2.816),TNM staging(OR=1.613,95%CI:1.223~2.126),and tumor differentiation(OR=1.510,95%CI:1.205~1.892)were independent factors affecting the prognosis of ICC.The area under the curve of the combination detection of circACTN4 and THBS1 mRNA on the prognosis of death in patients with ICC was 0.868,which was greater than that of the single index(0.812 and 0.784),with significant differences(Z=3.348,3.847,all P<0.001).Conclusion The expressions of CircACTN4 mRNA and THBS1 mRNA were increased in ICC,and they were associated with TNM stage,differentiation,and lymph node metastasis.These markers may serve as novel indicators to evaluate the poor prognosis of ICC patients.

intrahepatic cholangiocarcinomacircular RNAACTN4platelet thrombin protein 1

李顺乐、徐蒙、李蓉、赵向菊、柴祎超、贾鸾

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西安交通大学第二附属医院 普通外科,西安 710004

西安交通大学第二附属医院 麻醉科,西安 710004

西安交通大学第二附属医院 肿瘤科,西安 710004

西安交通大学第二附属医院 泌尿外科,西安 710004

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肝内胆管癌 环状核糖核酸辅肌动蛋白α4 血小板凝血酶蛋白1

陕西省重点研发计划(2021)陕西省重点研发计划(2023)陕西省科协青年人才托举计划(2023)

2021SF-2292023-YBSF-38620230301

2024

现代检验医学杂志
陕西省临床检验中心,陕西省人民医院

现代检验医学杂志

CSTPCD
影响因子:0.713
ISSN:1671-7414
年,卷(期):2024.39(3)