目的 探究核因子E2相关因子1(NFE2L1)、三结构域蛋白26(TRIM26)在胃癌患者组织表达与预后关系。方法 收集保定市第二中心医院电子病历系统2022年3月到2024年3月共80例胃癌患者为研究对象,根据患者在随访1年内出现死亡、肿瘤进展或严重并发症情况分预后不良和预后良好组。实时荧光定量PCR(qPCR)法检测胃癌及癌旁组织NFE2L1和TRIM26 mRNA表达;免疫组化法检测NFE2L1、TRIM26表达;Kaplan-Meier法分析生存率;多因素Logistic回归分析预后影响因素;通过受试者操作特征(ROC)曲线和决策曲线分析(DCA)评估NFE2L1、TRIM26 mRNA对预后预测效能。结果 胃癌组织NFE2L1、TRIM26 mRNA表达及NFE2L1、TRIM26蛋白阳性率高于癌旁组织(P＜0.05),与TNM分期相关(P＜0.05);Kaplan-Meier生存曲线表明胃癌组织NFE2L1、TRIM26阳性表达胃癌患者1年生存率为75.44%和73.58%均低于阴性表达95.65%和96.30%(log-rank χ2=4.243、5.972,P=0.039、0.015);预后不良组胃癌患者癌组织NFE2L1、TRIM26 mRNA水平均高于预后良好组(P＜0.05);多因素Logistic回归分析结果显示TNM分期、NFE2L1、TRIM26是影响预后危险因素(P＜0.05);ROC曲线表明NFE2L1、TRIM26 mRNA联合预测预后不良曲线下面积(AUC)值为0.944(95%CI=0.890~0.999),显著大于NFE2L1的AUC值0.815(95%CI=0.710~0.920)(Z=2.152,P=0.031)和TRIM26的AUC值0.837(95%CI=0.747~0.927)(Z=2.007,P=0.037)单独预测,同时DCA曲线可知联合预测在0.10~0.99高风险阈值范围内净获益率较高。结论 胃癌患者癌组织NFE2L1、TRIM26水平升高,联合对胃癌患者预后预测效能较高。
Abstract
Objective To investigate the expression of nuclear factor erythroid 2-related factor 1 (NFE2L1) and tripartite motif-containing protein 26 (TRIM26) in gastric cancer tissues and their correlation with patient prognosis. Method A total of 80 patients with gastric cancer admitted between March 2022 and March 2024 were enrolled from the electronic medical record system of our hospital. Patients were divided into the poor prognosis group and the good prognosis group according to the occurrence of death, tumor progression or severe complications within 1 year of follow-up. The mRNA expression levels of NFE2L1 and TRIM26 in gastric cancer tissues and adjacent normal tissues were detected by real-time fluorescent quantitative PCR (qPCR). The protein expressions of NFE2L1 and TRIM26 were determined by immunohistochemistry. Kaplan-Meier method was used for survival analysis. Multivariate Logistic regression analysis was performed to screen prognostic risk factors. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were adopted to evaluate the prognostic predictive efficiency of NFE2L1 and TRIM26 mRNA. Result The mRNA expressions and positive protein rates of NFE2L1 and TRIM26 were significantly higher in gastric cancer tissues than in adjacent normal tissues (P＜0.05), and their expressions were correlated with TNM stage (P＜0.05). Kaplan-Meier survival analysis revealed that the 1-year survival rates of patients with positive NFE2L1 and TRIM26 expression were 75.44% and 73.58%, which were markedly lower than those of patients with negative expression (95.65% and 96.30%, log-rank χ2=4.243, 5.972; P=0.039, 0.015). The mRNA levels of NFE2L1 and TRIM26 in the poor prognosis group were significantly higher than those in the good prognosis group (P＜0.05). Multivariate Logistic regression analysis identified TNM stage, NFE2L1 and TRIM26 as independent risk factors for poor prognosis (P＜0.05). The area under the curve (AUC) of combined NFE2L1 and TRIM26 mRNA for predicting poor prognosis was 0.944 (95%CI=0.890-0.999), which was significantly higher than the AUC of NFE2L1 alone (0.815, 95%CI=0.710-0.920, Z=2.152, P=0.031) and TRIM26 alone (0.837, 95%CI=0.747-0.927, Z=2.007, P=0.037). DCA demonstrated that the combined detection yielded a higher net clinical benefit within the high-risk threshold range of 0.10 to 0.99. Conclusion The expression levels of NFE2L1 and TRIM26 are upregulated in gastric cancer tissues, and their combined detection exhibits high efficiency in predicting the prognosis of patients with gastric cancer.
关键词
胃癌 /
核因子E2相关因子1 /
三结构域蛋白26 /
实时荧光定量PCR /
免疫组化 /
临床病理特征 /
预后 /
预测
Key words
Gastric cancer /
Nuclear factor erythroid 2 related factor 1 /
Tripartite motif-containing protein 26 /
Real-time fluorescent quantitative PCR /
Immunohistochemistry /
Clinicopathological features /
Prognosis /
Prediction
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