PCNA、Bcl-2及EGFR在喉癌组织中的表达及与临床病理特征、生存的关系

Expressions of PCNA, Bcl-2 and EGFR in laryngeal carcinoma tissues and their relationship with clinicopathologic features and survival of patients

摘要:

目的 探讨增殖细胞核抗原（PCNA）、B淋巴细胞瘤-2（Bcl-2）及表皮生长因子受体（EGFR）在喉癌组织中的表达及与临床病理特征、生存的关系。方法 选取2017年3月—2020年1月在苏州大学附属第一医院因喉癌行手术治疗的92例患者的喉癌组织及对应癌旁组织标本。检测癌组织与癌旁组织PCNA mRNA、Bcl-2 mRNA、EGFR mRNA相对表达量，多元线性回归分析其癌组织表达与临床病理特征的关系。随访3年，采用Kaplain-Maier曲线分析不同PCNA、Bcl-2、EGFR表达水平患者生存情况差异。结果 癌组织PCNA mRNA、Bcl-2 mRNA、EGFR mRNA相对表达量高于癌旁组织（P <0.05）。不同年龄、肿瘤部位患者PCNA mRNA、Bcl-2 mRNA、EGFR mRNA相对表达量比较，差异无统计学意义（P >0.05）；低分化，临床分期Ⅲ、Ⅳ期及淋巴结转移患者PCNA mRNA、Bcl-2 mRNA、EGFR mRNA相对表达量分别高于中、高分化，临床分期Ⅰ、Ⅱ期，无淋巴结转移患者（P <0.05）。多元线性回归分析结果显示，肿瘤分化程度、临床分期、淋巴结转移是喉癌组织PCNA mRNA、Bcl-2 mRNA、EGFR mRNA表达的影响因素。Kaplain-Maier曲线分析结果显示，PCNA mRNA高表达患者3年无进展生存率、总生存率分别为59.57%和70.21%，低于低表达患者的80.00%和88.89%（P <0.05）；Bcl-2 mRNA高表达患者3年无进展生存率、总生存率分别为60.78%和70.59%，低于低表达患者的80.49%和90.24%（P <0.05）；EGFR mRNA高表达患者3年无进展生存率、总生存率分别为59.09%和70.45%，低于低表达患者的79.17%、87.50%（P <0.05）。结论 喉癌组织PCNA、Bcl-2、EGFR呈高表达，且其高表达状态与肿瘤分期高、分化程度低、淋巴结转移有关，PCNA、Bcl-2、EGFR表达水平可在一定程度上反映患者预后。

Abstract:

Objective To investigate the expressions of proliferating cell nuclear antigen (PCNA), B cell lymphoma 2 (Bcl-2) and epidermal growth factor receptor (EGFR) in laryngeal carcinoma tissues and their relationship with clinicopathologic features and survival of patients.Methods The cancer and adjacent tissue samples from 92 patients undergoing surgical treatment for laryngeal cancer in our hospital from March 2017 to January 2020 were collected. The relative mRNA expressions of PCNA, Bcl-2 and EGFR in cancer and adjacent tissues were detected. Multiple linear regression was used to analyze the relationship between the expressions of the above indicators in cancer tissues and clinicopathological features. After 3 years of follow-up, Kaplan-Meier curve was applied to analyze the difference in survival of patients with different expressions of PCNA, Bcl-2 and EGFR.Results The relative mRNA expressions of PCNA, Bcl-2 and EGFR in cancer tissues were higher than those in adjacent tissues (P < 0.05). There was no difference in mRNA expressions of PCNA, Bcl-2 and EGFR among patients with different ages and tumor sites (P > 0.05). The relative mRNA expressions of PCNA, Bcl-2 and EGFR in patients with poorly-differentiated tumors, clinical stage Ⅲ to Ⅳ tumors, and lymph node metastasis were higher than those in patients with moderately- and well-differentiated tumors, clinical stage Ⅰ to Ⅱ tumors, and no lymph node metastasis, respectively (P < 0.05). Multiple linear regression analysis showed that the degree of tumor differentiation, clinical stage of tumors and lymph node metastasis were the factors affecting the mRNA expressions of PCNA, Bcl-2 and EGFR in laryngeal carcinoma tissues. Survival analysis via Kaplan-Meier curves revealed that the 3-year progression-free survival and the overall survival of patients with high mRNA expression of PCNA were 59.57% and 70.21%, which were lower than 80.00% and 88.89% in patients with low mRNA expression of PCNA (P < 0.05). The 3-year progression-free survival and the overall survival of patients with high mRNA expression of Bcl-2 were 60.78% and 70.59%, which were lower than 80.49% and 90.24% in patients with low mRNA expression of Bcl-2 (P < 0.05). The 3-year progression-free survival and overall survival of patients with high mRNA expression of EGFR were 59.09% and 70.45%, which were lower than 79.17% and 87.50% in patients with low mRNA expression of EGFR (P < 0.05).Conclusions PCNA, Bcl-2 and EGFR are highly expressed in laryngeal carcinoma tissues, and their high expressions are associated with advanced tumor stages, low degrees of tumor differentiation, and lymph node metastasis. The expressions of PCNA, Bcl-2 and EGFR reflect the prognosis of patients to a certain extent.