论文部分内容阅读
目的:探讨脑胶质瘤组织中CPEB1和bcl-2蛋白表达情况及与患者预后的关系。方法:选取2015年6月至2016年6月河南省南阳市第二人民医院收治的脑胶质瘤患者136例。术中收集患者脑胶质瘤组织和距离脑胶质瘤5 cm以上的癌旁正常组织。免疫组织化学法检测CPEB1和bcl-2蛋白表达情况。患者出院后随访3年，记录患者的生存情况。分析临床病理因素及CPEB1和bcl-2蛋白表达情况与生存的关系，采用多因素Cox回归模型分析患者生存影响因素。结果:脑胶质瘤组织中CPEB1、bcl-2蛋白阳性率高于癌旁正常组织，差异均有统计学意义[64.71%（88/136）比0（0/136），n χ2=21.648，n P<0.01；61.76%（84/136）比17.65%（24/136），n χ2=17.549，n P<0.01]。脑胶质瘤组织中CPEB1、bcl-2蛋白阳性率在不同肿瘤分期、分化程度、淋巴结转移患者中差异均有统计学意义（均n P<0.05）。至随访结束，88例CPEB1阳性者中生存68例（77.27%），48例阴性者中生存46例（95.83%），差异有统计学意义（n P<0.01）；84例bcl-2阳性者中生存64例（76.19%），52例阴性者中生存50例（96.15%），差异有统计学意义（n P<0.01）。多因素Cox回归分析显示，肿瘤分期（n HR=1.921，95% n CI 0.946～4.192，n P<0.01）、分化程度（n HR=1.816，95% n CI 0.921～4.955，n P<0.01）、淋巴结转移情况（n HR=2.059，95% n CI 1.075～5.629，n P<0.01）、术前Karnofsky评分（n HR=1.902，95% n CI 0.899～4.730，n P<0.01）、CPEB1蛋白表达（n HR=1.952，95% n CI 0.885～4.641，n P=0.001）、bcl-2蛋白表达（n HR=1.728，95% n CI 0.852～4.213，n P=0.003）是脑胶质瘤患者随访3年后生存的独立影响因素。n 结论:人脑胶质瘤组织中CPEB1和bcl-2蛋白均高表达，且可能与病情严重程度相关；二者表达是患者预后的独立影响因素。“,”Objective:To investigate the expressions of CPEB1 and bcl-2 in glioma tissues and their relationship with prognosis of patients.Methods:A total of 136 patients with glioma in Nanyang Second General Hospital of Henan Province from June 2015 to June 2016 were selected. The glioma tissues and adjacent normal tissues more than 5 cm away from glioma during the operation were collected. The expressions of CPEB1 and bcl-2 protein was detected by using immunohistochemistry. After discharge, patients were followed up for 3 years and recorded the survival status. The clinicopathologic factors and the association of the expressions of CPEB1 and bcl-2 protein with the survival status were also analyzed. Multivariate Cox regression model was used to analyze the factors affecting the survival of patients.Results:The positive rates of CPEB1 and bcl-2 protein in glioma tissues were higher than those in normal tissues adjacent to cancer [64.71% (88/136) vs. 0 (0/136), n χ2 = 21.648, n P < 0.01; 61.76% (84/136) vs. 17.65% (24/136), n χ2 = 17.549, n P < 0.01]. The positive rates of CPEB1 and bcl-2 protein expression in glioma tissues were statistically different in patients with different tumor staging, differentiation degree and lymph node metastasis (all n P < 0.05). By the end of the follow-up, 68 (77.27%) survived in 88 CPEB1 positive patients and 46(95.83%) survived in 48 CPEB1 negative patients, and the difference was statistically significant ( n P < 0.01); 64 (76.19%) survived in 84 bcl-2 positive patients and 50 (96.15%) survived in 52 bcl-2 negative patients; and the difference was statistically significant ( n P < 0.01). Multivariate Cox regression analysis showed that tumor staging ( n HR = 1.921, 95% n CI 0.946-4.192, n P < 0.001), differentiation degree ( n HR = 1.816, 95% n CI 0.921-4.955, n P < 0.01), lymph node metastasis ( n HR = 2.059, 95% n CI 1.075-5.629, n P < 0.01), preoperative Karnofsky score ( n HR = 1.902, 95% n CI 0.899-4.730, n P < 0.01), CPEB1 protein expression ( n HR = 1.952, 95% n CI 0.885-4.641, n P = 0.001) and bcl-2 protein expression (n HR = 1.728, 95% n CI 0.852-4.213, n P = 0.003) were independent factors affecting survival of glioma patients after 3-year follow-up.n Conclusion:CPEB1 and bcl-2 protein are highly expressed in human glioma tissues, which is related with the severity of the disease. The expressions of both are independent prognostic factors.