首页|老年鼻咽癌癌组织中Kruppel样因子5及Kruppel样因子9表达与患者复发的相关性

老年鼻咽癌癌组织中Kruppel样因子5及Kruppel样因子9表达与患者复发的相关性

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目的 探讨老年鼻咽癌癌组织中Kruppel样因子 5(KLF5)、Kruppel样因子 9(KLF9)表达与患者复发间的关系.方法 回顾性分析 2016 年 5 月至 2018 年 5 月湖南省脑科医院收治的 263 例老年鼻咽癌患者的临床资料,患者治疗后均行5 年院外随访,观察患者是否出现复发.通过Western blotting技术检测老年鼻咽癌患者癌组织中KLF5、KLF9 相对蛋白表达量,比较复发患者与非复发患者的基础资料信息[性别、年龄、国际抗癌联盟(UICC)分期、病理类型、疗程延长时间、放疗剂量、是否放疗联合化疗、是否鼻腔受侵、是否口咽受侵、是否颅底骨质受侵、是否颅内受损、是否颅神经损伤]及KLF5、KLF9 差异.通过多因素logistic逐步回归分析老年鼻咽癌患者复发的危险因素.采用SPSS 22.0 软件进行数据分析.根据数据类型,组间比较分别采用t检验及χ2 检验.结果 263 例老年鼻咽癌患者治疗结束后行 5 年院外随访,复发患者共 27 例(10.27%).与非复发组患者相比,复发组患者UICC分期Ⅲ~Ⅳ期、未行放疗联合化疗、颅底骨质受侵、颅神经损伤占比较高,差异有统计学意义(均P<0.05).与非复发组患者相比,复发组患者KLF5、KLF9 相对蛋白表达量下降,差异有统计学意义(P<0.05).对KLF5、KLF9 进行受试者工作特征(ROC)曲线分析,其对老年鼻咽癌患者复发有较好的预测价值,且联合预测价值更高,曲线下面积分别为 0.800、0.790、0.894,且均有P<0.05.多因素logistic回归分析显示,UICC分期Ⅲ~Ⅳ期(OR=3.420,95%CI 1.715~6.820)、未行放疗联合化疗(OR=1.434,95%CI 1.106~1.859)、颅底骨质受侵(OR=2.790,95%CI 1.337~5.822)、颅神经损伤(OR=1.249,95%CI 1.026~1.520)、KLF5<2.495(OR=4.453,95%CI 1.469~13.498)、KLF9<0.305(OR=2.719,95%CI 1.604~4.609)是老年鼻咽癌患者复发的危险因素.结论 老年鼻咽癌患者癌组织内KLF5、KLF9 表达下降,且KLF5、KLF9表达为患者复发的影响因素.
Correlation of expression of Kruppel-like factor 5 and Kruppel-like factor 9 in cancer tissues with recurrence of nasopharyngeal carcinoma in elderly patients
Objective To investigate the relationship of the expressions of Kruppel-like factor 5(KLF5)and Kruppel-like factor 9(KLF9)with the recurrence of nasopharyngeal carcinoma(NPC)in the elderly patients.Methods A retrospective analysis was made of the clinical data of 263 elderly NPC patients admitted to Hunan Provincial Brain Hospital from May 2016 to May 2018.All patients were followed up for 5 years after treatment to observe for recurrence.Protein expression levels of KLF5 and KLF9 in the cancer tissues of the patients were detected using Western blotting technique.The recurrent and non-recurrent patients were compared for the basic data[gender,age,union for international cancer control(UICC)stage,pathological type,duration of extended treatment,radiotherapy dose,radiotherapy combined with chemotherapy,nasal invasion,oropharyngeal invasion,skull base bone invasion,intracranial damage,cranial nerve injury]and KLF5 and KLF9.Multivariate logistic regression was used to analyze the risk factors of recurrence in the elderly NPC patients.SPSS 22.0 was used for statistical analysis.Comparison between two groups was performed using t test or χ2 test depending on the data type.Results A total of 263 elderly NPC patients were followed up for 5 years after treatment,and 27(10.27%)expe-rienced relapse.Compared with the non-recurrent patients,the recurrent patients had higher proportions of those with UICC stage Ⅲ toⅣ,those without radiotherapy combined with chemotherapy,those with skull base bone invasion,and those with cranial nerve injury,and the differences were statistically significant(all P<0.05).Compared with non-relapse patients,the expression of KLF5 and KLF9 in the relapse patients decreased,and the differences were statistically significant(P<0.05).Receiver operating characteristic(ROC)curve analysis of KLF5 and KLF9 showed better predictive value for the NPC recurrence in the elderly patients,and the combined predictive value was higher,and the area under the curve(AUC)was 0.800,0.790 and 0.894,respectively(P<0.05).Multivariate logistic regression analysis showed that UICC stage Ⅲ-Ⅳ(OR=3.420,95%CI 1.715-6.820),no radiotherapy combined with chemotherapy(OR=1.434,95%CI 1.106-1.859),skull base bone invasion(OR=2.790,95%CI 1.337-5.822),cranial nerve injury(OR=1.249,95%CI 1.026-1.520),KLF5<2.495(OR=4.453,95%CI 1.469-13.498),KLF9<0.305(OR=2.719,95%CI 1.604-4.609)were risk factors for NPC recurrence in the elderly patients.Conclusion The expressions of KLF5 and KLF9 in the cancer tissues of the elderly NPC patients decrease and are factors affecting the recurrence.

agednasopharyngeal carcinomarecurrenceKruppel-like factor 5Kruppel-like factor 9

徐敏、周金、范冶、徐飞

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湖南省脑科医院病理科,长沙 410007

湖南省脑科医院检验科,长沙 410007

老年人 鼻咽癌 复发 Kruppel样因子5 Kruppel样因子9

湖南省自然科学基金科卫联合项目

2021JJ70012

2024

中华老年多器官疾病杂志
中国人民解放军总医院老年心血管病研究所

中华老年多器官疾病杂志

CSTPCD
影响因子:0.728
ISSN:1671-5403
年,卷(期):2024.23(4)
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