摘要
目的研究手术标本Yes相关蛋白1(YAP1)、POU2家族同源框2(POU2F2)和组织蛋白酶D(Cath-D)表达与局限性肾癌术后复发的相关性及预测意义。方法回顾性分析2019年1月至2022年3月新乡医学院第一附属医院收治的282例局限性肾癌手术患者的临床资料,根据术后2年随访期内(2例失访)复发情况分为复发组42例和未复发组238例。比较两组患者的基线资料以及手术标本YAP1、POU2F2、Cath-D表达水平,采用多因素Logistic回归分析局限性肾癌术后复发的影响因素,采用受试者工作特征(ROC)曲线分析手术标本YAP1、POU2F2和Cath-D表达单一及联合预测局限性肾癌术后复发价值,采用Pearson相关分析法分析手术标本YAP1、POU2F2和Cath-D表达与复发时间的相关性。结果复发组患者的2017AJCCTNM分期T2期、Fuhrman分级Ⅳ级患者占比分别为80.95%、40.48%,明显高于未复发组患者的62.31%、21.85%,差异均有统计学意义(P<0.05);复发组患者的YAP1阳性率、POU2F2 mRNA和Cath-D阳性率分别为78.57%、1.70±0.36和83.33%,明显高于未复发组患者的47.90%、1.48±0.41、50.00%,差异均有统计学意义(P<0.05);校正前多因素Logistic回归分析结果显示,2017AJCCTNM分期T2期、Fuhrman分级>Ⅱ级、YAP1阳性、POU2F2mRNA、Cath-D阳性均与局限性肾癌术后复发相关(P<0.05),校正后YAP1阳性、POU2F2 mRNA和Cath-D阳性仍是局限性肾癌术后复发的独立相关危险因素(P<0.05);ROC分析结果显示,三者联合预测局限性肾癌术后复发的AUC为0.915,敏感度为80.95%,特异度为89.00%,明显高于各指标单独预测(P<0.05);Pearson相关性分析结果显示,手术标本YAP1、POU2F2、Cath-D表达与复发时间呈负相关(r=-0.802、-0.769、-0.834,P<0.05)。结论局限性肾癌患者手术标本YAP1、POU2F2和Cath-D表达水平与术后复发密切相关,其联合预测局限性肾癌术后复发具有良好参考价值。
Objective To investigate the correlation and predictive significance of the expression of Yes-associated protein 1(YAP1),POU2 family homeobox 2(POU2F2),and cathepsin D(Cath-D)with surgical specimens with postoperative recurrence of localized renal cell carcinoma.Methods A retrospective analysis was conducted on the clinical data of 282 patients with localized renal cancer who underwent surgery at the First Affiliated Hospital of Xinxiang Medical University from January 2019 to March 2022.According to the recurrence status during the 2-year follow-up period(2 cases lost to follow-up),the patients were divided into a recurrence group of 42 cases and a non-recurrence group of 238 cases.The baseline data and the expression levels of YAP1,POU2F2,and Cath-D in surgical specimens were compared between the two groups.Multivariate logistic regression analysis was used to analyze the factors affecting the recurrence of localized renal cancer after surgery.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of YAP1,POU2F2,and Cath-D expression in surgical specimens for predicting the recurrence of localized renal cancer after surgery.Pearson correlation analysis was used to analyze the correlation between the expression of YAP1,POU2F2,and Cath-D in surgical specimens and the recurrence time.Results The proportions of patients with 2017 AJCC TNM stage T2 and Fuhrman gradeⅣin the recurrence group were 80.95%and 40.48%,respectively,which were significantly higher than 62.31%and 21.85%in the non-recurrence group(P<0.05).The positive rates of YAP1,POU2F2 mRNA,and Cath-D in the recurrence group were 78.57%,1.70±0.36,and 83.33%,respectively,which were significantly higher than 47.90%,1.48±0.41,and 50.00%in the non-recurrence group(P<0.05).The results of the multi-factor logistic regression analysis before correction showed that the 2017 AJCC TNM staging T2 stage,Fuhrman grading>GradeⅡ,YAP1 positivity,POU2F2 mRNA,and Cath-D positivity were all associated with local re currence after surger
作者
刘沛
韩广业
张春锋
李振辉
LIU Pei;HAN Guang-ye;ZHANG Chun-feng;LI Zhen-hui(WardⅡ,Department of Urology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan,CHINA)
出处
《海南医学》
CAS
2024年第16期2339-2344,共6页
Hainan Medical Journal
基金
2022年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20220607)。
