摘要
目的 探讨钙黏蛋白相关蛋白(cadherin associated protein beta 1,CTNNB1)、肿瘤抑制因子P53(tumor suppressor factor P53,TP53)蛋白在儿童肝母细胞瘤(hepatoblastoma, HB)组织中的表达及与病理特征、预后的关系。方法 选取2017-06/2020-06月作者医院收治的72例HB患儿为研究对象,手术留取癌组织标本及对应的癌旁组织。连续随访3年,记录患儿的预后生存情况,并计算总生存率(overall survival, OS)。采用免疫组织化学法检测CTNNB1、TP53蛋白在HB患儿癌组织及癌旁组织中的表达情况;采用χ~2检验分析CTNNB1、TP53蛋白表达与HB患儿临床病理特征的关系;采用多因素Cox回归分析探讨HB患儿预后的影响因素。结果 HB患儿癌组织中CTNNB1阳性表达率(76.39%)高于对照组(43.06%),TP53阴性表达率(70.83%)高于对照组(38.89%)(P均<0.05)。初诊甲胎蛋白浓度≥100μg/L、POST-TEXT分期Ⅲ~Ⅳ期、肿瘤直径≥3 cm、有肿瘤侵袭或转移HB患儿的CTNNB1阳性表达率、TP53阴性表达率高于初诊甲胎蛋白<100μg/L、POST-TEXT分期Ⅰ~Ⅱ期、肿瘤直径<3 cm、无肿瘤侵袭或转移HB患儿(P均<0.05)。初诊甲胎蛋白≥100μg/L、POST-TEXT分期Ⅲ~Ⅳ期、有肿瘤侵袭或转移、CTNNB1阳性表达、TP53阴性表达的HB患儿3年OS低于初诊甲胎蛋白<100μg/L、POST-TEXT分期Ⅰ~Ⅱ期、无肿瘤侵袭或转移、CTNNB1阴性表达、TP53阳性表达的HB患儿(P均<0.05)。多因素Cox回归分析结果显示,POST-TEXT分期Ⅲ~Ⅳ期(HR=2.077,95%CI:1.423~3.032)、有肿瘤侵袭或转移(HR=2.291,95%CI:1.536~3.417)、CTNNB1阳性表达(HR=2.757,95%CI:1.781~4.268)、TP53阴性表达(HR=2.477,95%CI:1.635~3.753)是HB患儿预后的独立危险因素(P<0.05)。结论 HB患儿癌组织中CTNNB1主要呈阳性表达,而TP53主要呈阴性表达,二者与初诊甲胎蛋白、POST-TEXT分期、肿瘤直径、有肿瘤侵袭或转移密切相关,有望作为评估HB患儿预后的生物学指标。
Objective To explore the expression of cadherin associated protein beta 1(CTNNB1) and tumor suppressor factor P53(TP53) protein in hepatoblastoma(HB) tissues of children and its relationship with pathological features and prognosis.Methods A total of 72 children with HB admitted to author′s hospital from June 2017 to June 2020 were selected as the objects of this study, cancer tissues specimens and corresponding para-carcinoma tissue were retained during the surgery. The patients were followed up for 3 years, and the prognosis was recorded and the overall survival(OS) was calculated. The expressions of CTNNB1 and TP53 protein in cancer tissues and para-carcinoma tissue of HB children were detected by immunohistochemical method;the relationship between the expressions of CTNNB1, TP53 protein and the clinicopathological characteristics of HB children was analyzed by χ~2 test;the prognostic factors of HB children were investigated by multivariate Cox regression analysis.Results The positive expression rate of CTNNB1 in the cancer tissues of HB children(76.39%) was higher than that in control group(43.06%), and the negative expression rate of TP53(70.83%) was higher than that in control group(38.89%)(all P<0.05). The positive expression rate of CTNNB1 and negative expression rate of TP53 in newly diagnosed HB children with alpha-fetoprotein ≥100 μg/L, POST-TEXT stage Ⅲ to Ⅳ, tumor diameter ≥3 cm, tumor with invasion or metastasis were higher than those in newly diagnosed HB children with alpha-fetoprotein <100 μg/L, POST-TEXT stage Ⅰ to Ⅱ, tumor diameter <3 cm and tumor without invasion or metastasis(all P<0.05). The 3-year OS rate of children with alpha-fetoprotein ≥100 μg/L, POST-TEXT stage Ⅲ to Ⅳ, tumor HB with invasion or metastasis, positive expression of CTNNB1, negative expression of TP53 was lower than that of newly diagnosed HB children with alpha-fetoprotein <100 μg/L, POST-TEXT stage Ⅰ to Ⅱ, tumor without invasion or metastasis, negative expression of CTNNB1 and positive expres
作者
许彩霞
盛玉
XU Caixia;SHENG Yu(Department of General Surgery,Affiliated Children's Hospital of Nanjing Medical Uni-versity,Nanjing Jiangsu 210008,China)
出处
《联勤军事医学》
CAS
2024年第4期304-308,共5页
Military Medicine of Joint Logistics
关键词
钙黏蛋白相关蛋白
肿瘤抑制因子P53
儿童
肝母细胞瘤
病理特征
预后
Cadherin associated protein beta 1
Tumor suppressor factor P53
Children
Hepatoblastoma
Patho-logical feature
Prognosis
