江波,王兴远,周伟,龙翔宇,朱其荣,应伟,李程,汪建,林超,刘晓川
JIANG Bo,WANG Xingyuan,ZHOU Wei,LONG Xiangyu,ZHU Qirong,YING Wei,LI Cheng,WANG Jian,LIN Chao,LIU Xiaochuan

• 1:四川大学华西广安医院肿瘤科
• 2:川北医学院附属医院感染科
• 3:广安市广安区人民医院心电图室
• 4:四川大学华西广安医院心胸外科

摘要(Abstract)：

目的 探讨直肠癌患者化疗前后体内血小板内皮黏附分子-1 (PECAM-1)、三重基序蛋白14(TRIM14)水平变化及对预后的评估意义。方法 124例直肠癌患者行6～8周化疗，化疗结束后采用计算机体层成像（CT）评估疗效，并分为完全缓解（CR）组（n=39）、部分缓解（PR）组（n=54）、疾病稳定（SD）组（n=22）及疾病进展（PD）组（n=9），于化疗前后直肠镜钳取患者化疗前后病灶组织，采用免疫印迹法检测肿瘤组织中PECAM-1和TRIM14表达，电话或门诊随访患者1年，采用Spearman相关性分析和受试者工作特征曲线（ROC）分析直肠癌患者化疗后PECAM-1、TRIM14表达水平与预后的相关性及价值，采用单因素和多因素Cox回归分析影响直肠癌患者预后的因素。结果 化疗前，PR、SD、PD组肿瘤组织标本中PECAM-1、TRIM14表达水平较CR组升高（P<0.05）,PD组PECAM-1表达水平较PR组升高（P<0.05）,SD、PD组TRIM14表达水平较PR组升高（P<0.05）,PD组PECAM-1表达水平较SD组升高（P<0.05）；化疗后，PR、SD、PD组患者化疗后PECAM-1、TRIM14表达水平较CR组升高（P<0.05）,PD、SD组患者PECAM-1、TRIM14表达水平较PR组升高（P<0.05）,PD组患者PECAM-1、TRIM14表达水平较SD组升高（P<0.05）；直肠癌患者化疗后PECAM-1、TRIM14表达水平与其预后不良呈正相关（r=0.528、0.497,P<0.05）;PECAM-1、TRIM14联合诊断指标曲线下面积为0.965，与各单项指标曲线下面积差异无统计学意义（P> 0.05），二指标最佳截断值分别为2.09、1.48；多因素Cox回归分析显示，TNM分期Ⅳ期、PECAM-1含量≥2.09及TRIM14含量≥1.48是直肠癌患者预后不良的危险因素（P<0.05）。结论 化疗后直肠癌患者肿瘤组织中PECAM-1、TRIM1表达对预后有较高的评估价值，PECAM-1、TRIM1高表达提示患者预后不良。
Objective To investigate the changes of platelet endothelial adhesion molecule-1(PECAM-1) and triple motif protein 14( TRIM14) levels of patients with rectal cancer before and after chemotherapy and their prognostic significance.Methods One hundred and twenty-four patients with rectal cancer underwent chemotherapy for 6-8 weeks of, and were divided into complete response(CR) group(n= 39), partial response(PR) group(n= 54), stable disease(SD) group(n= 22)and progression of disease( PD) group(n= 9). The focal tissues of the patients before and after chemotherapy were collected by colonoscopy forceps, and the expressions of PECAM-1 and TRIM14 in tumor tissues were detected by western blotting. Telephone or outpatient follow-up were carried out for1 year. Spearman correlation analysis and receiver operating characteristic curve(ROC) were used to analyze the correlation and value of PECAM-1, TRIM14 expression levels and prognosis of patients with rectal cancer after chemotherapy. Univariate and multivariate Cox regression analysis were used to detect the prognostic factors.Results Before chemotherapy, compared with CR group, the expression levels of PECAM-1 and TRIM14 in tumor tissue samples of PR, SD, and PD groups were higher, and the differences were statistically significant(P< 0. 05); PECAM-1 expression level was higher in PD group than in PR group, and TRIM14 expression level was higher in SD andPD groups than in RP group, with statistical significance(P< 0. 05); the PECAM-1 expression level was higher in PD group than in SD group, and the differences were statistically significant(P< 0. 05). After chemotherapy,the expression levels of PECAM-1 and TRIM14 were higher in PR, SD and PD groups than those in CR group, with statistical difference(P< 0. 05);the expression levels of PECAM-1 and TRIM14 were higher in PD and SD groups than those in PR group, with statistical difference(P< 0. 05); the expression levels of PECAM-1 and TRIM14 were higher in PD group than those in SD group, with statistical difference(P< 0. 05); and the expression levels of PECAM-1 and TRIM14 were positively correlated with poor prognosis in patients with rectal cancer(r= 0. 528, 0. 497;P< 0. 05). The area under the curves of PECAM-1 and TRIM14 combined diagnostic indexes was 0. 965, without statistical significance, compared with the area under the curve of each single index(P> 0. 05). The optimal truncation values of the two indexes were 2. 09 and 1. 48, respectively. Multivariate Cox regression analysis showed that TNM stage Ⅳ, PECAM-1 content ≥2. 09 and TRIM14 content ≥1. 48 were risk factors for poor prognosis in patients with rectal cancer(P< 0. 05).Conclusion The expression of PECAM-1 and TRIM1 in tumor tissues of patients with rectal cancer after chemotherapy has high prognostic value, and the high expression of PECAM-1 and TRIM1 suggests poor prognosis.

关键词(KeyWords)： 直肠肿瘤;预后;血小板内皮黏附分子-1;化疗;三重基序蛋白14;相关性;评估价值
rectal neoplasms;prognosis;platelet endothelial adhesion molecule-1 (PECAM-1);chemotherapy;triple motif protein 14 (TRIM14);correlation;assessed value

Abstract:

Keywords:

基金项目(Foundation): 四川省卫生计生委课题（17PJ190）

作者(Author): 江波,王兴远,周伟,龙翔宇,朱其荣,应伟,李程,汪建,林超,刘晓川
JIANG Bo,WANG Xingyuan,ZHOU Wei,LONG Xiangyu,ZHU Qirong,YING Wei,LI Cheng,WANG Jian,LIN Chao,LIU Xiaochuan

DOI: 10.19367/j.cnki.2096-8388.2022.03.014

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