TMEM16A表达与结直肠癌预后的关系

发布时间：2018-04-29 14:47

本文选题：结直肠癌 + TMEM16A　；参考：《大连医科大学》2017年硕士论文

【摘要】：目的:探讨TMEM16A蛋白在结直肠癌组织中的表达情况与结直肠癌患者预后之间的关系,从而为结直肠癌患者的临床治疗提供新的思路和方法,同时为评估结直肠癌患者的预后提供新的检测指标。方法:1.搜集大连医科大学附属第一医院2009年6月-2011年12月经病理证实并得到随访的结直肠癌患者的术后癌组织蜡块96例,所有患者术前均未进行放化疗和其它相应的抗肿瘤治疗,亦不伴有其他恶性肿瘤,包括:男性58例,女性38例,年龄30岁-80岁,中位年龄62.2岁;高、中、低分化分别为13例、61例、22例;无淋巴结转移者63例,伴淋巴结转移者33例。DukesA期6例,DukesB期57例,DukesC期33例。术后放化疗者54例,无放化疗者42例,所有患者的病例资料完整。生存时间记录方法:手术日-死亡日或手术日-最后一次随访日期。2.用免疫组织化学SP法检测TMEM16A蛋白在结直肠癌组织中的表达情况,分为高表达组和低表达组。3.回顾性分析患者的临床病例资料,分析TMEM16A蛋白表达的水平与不同的临床分期、病理特征及临床预后的相关性。分别绘制出TMEM16A蛋白高表达组和低表达组的Kaplan-Meier生存曲线,用Log-rank检验来比较两组间的生存时间差异。单因素回归分析结直肠癌患者术后不良预后的相关因素,多因素回归分析TMEM16A蛋白的高表达是否为结直肠癌患者不良预后的独立因子。结果:1、免疫组化法检测结直肠癌组织中TMEM16A蛋白的表达情况96例结直肠癌中TMEM16A蛋白高表达组44例(45.8%),低表达组52例(54.2%)。2、结直肠癌组织中TMEM16A蛋白的表达与患者各临床病理参数之间的关系结直肠癌组织中TMEM16A蛋白的表达程度与患者的性别、年龄、肿瘤大小及肿瘤分化的程度无相关性(P0.05),而与肿瘤的浸润深度、淋巴结转移情况及临床Dukes分期有显著的相关性(P0.05);浸润≤T2组TMEM16A蛋白的高表达率为0.00%,而浸润T2组TMEM16A蛋白的高表达率为48.89%,两组间的表达差异有统计学意义(X~2=5.415,P=0.02);临床分期的分组中,Dukes A+B期的TMEM16A蛋白的高表达率为34.92%,Dukes C期的TMEM16A的高表达率为66.67%,两组间的表达差异有统计学意义(X~2=8.791,P=0.003);淋巴结转移组TMEM16A高表达率为66.672%,无淋巴结转移组的阳性表达率为34.92%,两组间的表达差异有统计学意义(X~2=8.791,P=0.003)。3、结直肠癌中TMEM16A蛋白的表达与患者预后的相关性分析Kaplan-Meier生存曲线和Log-rank检验的结果显示,TMEM16A蛋白高表达组患者的5年生存率明显低于TMEM16A蛋白低表达组(68.2%vs.92.3%),差异有统计学意义(Log-rank,X~2=9.892,P=0.002)。COX单因素分析结果发现,结直肠癌患者的预后与性别(P=0.767)、肿瘤大小(P=0.084)、肿瘤的分化程度(P=0.557)、肿瘤浸润深度(P=0.827)无相关性,但与患者的年龄(RR=5.671,95%CI:1.303-24.678,P0.05)、有无淋巴结转移(RR=3.645,95%CI:1.411-9.415,P0.05)、肿瘤 Dukes 分期(RR=3.645,95%CI:1.411-9.415,P0.05)、TMEM16A 蛋白的表达(RR=4.972,95%CI:1.635-15.120,P0.05)相关。COX多因素分析回归结果显示,校正患者性别、年龄、肿瘤的分化程度、肿瘤临床分期及淋巴结转移等影响因素之后,TMEM16A蛋白的高表达(P0.05,RR=6.467,95%CI:1.777-23.538)是判断结直肠癌患者不良预后的独立预后因子。结论:1.TMEM16A蛋白的表达水平与结直肠癌的浸润、Dukes分期、淋巴结转移密切相关。2.TMEM16A蛋白的高表达是结直肠癌患者独立的不良预后因子。3.年龄、Dukes分期、淋巴结转移、TMEM16A蛋白的表达水平以及术后有无放化疗都影响结直肠癌患者的术后预后。
[Abstract]:Objective: To investigate the relationship between the expression of TMEM16A protein in colorectal cancer and the prognosis of colorectal cancer patients, so as to provide new ideas and methods for the clinical treatment of colorectal cancer patients, and to provide new detection indicators for evaluating the prognosis of colorectal cancer patients. 1. collect the First Affiliated Hospital of Dalian Medical University, 200 9 years' June -2011 12 menstrual pathology confirmed and followed up with colorectal cancer tissue wax blocks in 96 cases of colorectal cancer patients. All patients did not undergo radiotherapy and chemotherapy and other corresponding antitumor treatment before operation, and no other malignant tumors, including 58 men, 38 women, 30 years old and 62.2 years of age; high, middle, and low differentiation, respectively. 13 cases, 61 cases, 22 cases, 63 cases with lymph node metastasis, 33 cases of.DukesA phase with lymph node metastasis, 57 cases in DukesB stage, 33 cases in DukesC stage. 54 cases were treated with radiotherapy and chemotherapy after operation, 42 cases without radiotherapy and chemotherapy. The survival time records methods: operation day death day, operation day and last follow-up date.2. use immune tissue. The expression of TMEM16A protein in colorectal cancer tissues was detected by chemical SP, and the clinical data of patients with high expression group and low expression group.3. were analyzed retrospectively. The correlation between the level of TMEM16A protein expression and different clinical stages, pathological features and clinical prognosis were analyzed. The high expression group and low table of TMEM16A protein were respectively drawn. The Kaplan-Meier survival curve of the group was compared with the Log-rank test to compare the differences in the survival time between the two groups. Single factor regression analysis was used to analyze the factors associated with the postoperative adverse prognosis of colorectal cancer patients. Multiple regression analysis of the high expression of TMEM16A protein was an independent factor for the poor prognosis of colorectal cancer patients. Results: 1, immunohistochemical method detection junction The expression of TMEM16A protein in rectal cancer tissue 96 cases of high expression of TMEM16A protein (45.8%) in colorectal cancer, 52 cases (54.2%) of low expression group (54.2%).2, the relationship between the expression of TMEM16A protein in colorectal cancer tissue and the clinicopathological parameters of the patients, the expression of TMEM16A protein in colorectal cancer tissues and the sex, age, and swelling of the patients There was no correlation between the size of tumor and the degree of tumor differentiation (P0.05), but there was a significant correlation with the depth of tumor invasion, lymph node metastasis and clinical Dukes staging (P0.05), and the high expression rate of TMEM16A protein in the group of infiltrating T2 was 0%, while the high rate of expression of TMEM16A protein in the infiltrating T2 group was 48.89%, and the difference in the expression of the two groups was statistically significant (X~). 2=5.415, P=0.02); in the group of clinical stages, the high expression rate of TMEM16A protein in Dukes A+B stage was 34.92%, the high expression rate of TMEM16A in Dukes C phase was 66.67%. The difference of expression between two groups was statistically significant (X~2=8.791, P=0.003), the TMEM16A high expression rate of lymph node metastasis group was 66.672%, and the positive expression rate of no lymph node metastasis group was 34.92%, The expression difference between the two groups was statistically significant (X~2=8.791, P=0.003).3, the correlation between the expression of TMEM16A protein in colorectal cancer and the prognosis of patients, the results of Kaplan-Meier survival curve and Log-rank test showed that the 5 year survival rate of the patients with high expression of TMEM16A protein was significantly lower than that of the low expression group of TMEM16A protein (68.2%vs.92.3%). A statistically significant (Log-rank, X~2=9.892, P=0.002).COX single factor analysis found that the prognosis of colorectal cancer patients was not related to sex (P=0.767), tumor size (P=0.084), the degree of tumor differentiation (P=0.557), and the depth of tumor invasion (P=0.827), but with the patient's age (RR=5.671,95%CI:1.303-24.678, P0.05), there was no lymph node metastasis (RR=) 3.645,95%CI:1.411-9.415, P0.05), tumor Dukes staging (RR=3.645,95%CI:1.411-9.415, P0.05), TMEM16A protein expression (RR=4.972,95%CI:1.635-15.120, P0.05) related.COX multivariate analysis of regression results showed that the correction of patient sex, age, tumor differentiation, tumor clinical stage and lymph node metastasis, and other factors, TMEM16, TMEM16. The high expression of A protein (P0.05, RR=6.467,95%CI:1.777-23.538) is an independent prognostic factor for the poor prognosis of colorectal cancer patients. Conclusion: the expression level of 1.TMEM16A protein and the invasion of colorectal cancer, Dukes staging, and lymph node metastasis closely related to the high expression of.2.TMEM16A protein are independent prognostic factors of colorectal cancer patients.3. years. Age, Dukes stage, lymph node metastasis, TMEM16A protein expression, and postoperative radiotherapy and chemotherapy all affect the prognosis of patients with colorectal cancer.

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34

【参考文献】