肢体脂肪肉瘤组织中沉默信息调节因子2相关酶1的表达及其与预后的关系

Expression of silencing information regulator 2-associated enzyme 1 in liposarcoma of extremities and its relationship with prognosis

摘要:

目的 探讨沉默信息调节因子2相关酶1（SIRT1）在肢体脂肪肉瘤组织中的表达及其与预后的关系。方法 采取回顾性病例对照研究方法。使用免疫组织化学SP法检测67例肢体脂肪肉瘤患者脂肪肉瘤组织中SIRT1蛋白的表达，并与其中11例肢体脂肪肉瘤肺转移组织和30例正常肢体脂肪瘤组织比较。比较不同临床病理特征肢体脂肪肉瘤患者SIRT1蛋白的阳性表达率。多因素Cox逐步回归模型分析影响肢体脂肪肉瘤患者生存预后的危险因素。结果 正常肢体脂肪瘤组织、肢体脂肪肉瘤组织及肢体脂肪肉瘤肺转移组织中SIRT1蛋白阳性表达率分别为10.00%、59.70%及90.91%，3组比较，差异有统计学意义（P <0.05）；肢体脂肪肉瘤组织及肢体脂肪肉瘤肺转移组织中SIRT1蛋白阳性表达率均高于正常肢体脂肪瘤组织（P <0.014），肢体脂肪肉瘤肺转移组织中SIRT1蛋白阳性表达率高于肢体脂肪肉瘤组织（P <0.014）。肢体脂肪肉瘤患者不同性别、年龄、肿瘤大小及发病部位的SIRT1蛋白阳性表达率比较，差异无统计学意义（P >0.05）；不同肿瘤深度、Enneking外科分期、病理学类型及有无肺转移患者的SIRT1蛋白阳性表达率比较，差异有统计学意义（P <0.05）。40例SIRT1蛋白阳性表达者中存活13例，死亡27例，最短总生存期为2个月，最长总生存期为74个月。27例SIRT1蛋白阴性表达者中存活20例，死亡7例，最短总生存期为5个月，最长总生存期为81个月。SIRT1蛋白阳性表达者的总生存期短于SIRT1蛋白阴性表达者（P <0.05）。不同年龄、Enneking外科分期、SIRT1蛋白表达、病理学类型及有无肺转移患者的生存预后比较，差异有统计学意义（P <0.05）。不同性别、肿瘤大小、发病部位及肿瘤深度患者的生存预后比较差异均无统计学意义（P >0.05）。Cox逐步回归模型结果显示，SIRT1蛋白阳性表达者的死亡风险是SIRT1蛋白阴性表达者的1.403倍（P <0.05）。结论 SIRT1蛋白的异常表达可能与肢体脂肪肉瘤的发生发展和侵袭转移有关，SIRT1蛋白不仅在肢体脂肪肉瘤组织和肢体脂肪肉瘤肺转移组织中高度表达，且与患者预后显著相关，可作为临床判断肢体脂肪肉瘤预后的一个潜在标志物。

Abstract:

Objective To investigate the expression of SIRT1 in liposarcomas of extremities and its relationship with prognosis.Methods A retrospective case-control study was used. The expression of SIRT1 protein in liposarcomas of 67 patients with limb liposarcoma was detected by immunohistochemical SP method, and compared with 11 cases of lung metastases and 30 cases of normal lipoma. In addition, the clinical pathology features and prognosis of patients with Liposarcoma of extremities were analyzed.Results The positive expression rates of SIRT1 protein were 10.00%, 59.70%, and 90.91% in lipoma, liposarcoma, liposarcoma with lung metastases, respectively, with significant difference (P < 0.05), and the positive expression rate of SIRT1 protein in liposarcomas and liposarcomas with lung metastasis was significantly higher than that in lipomas of Limbs (P < 0.014), the positive expression rate of SIRT1 protein in liposarcomas with lung metastasis was higher than that in liposarcomas (P < 0.014). There were no significant differences in the expression of SIRT1 protein in different sex, age, tumor size, and location (P > 0.05). There were significant differences in the expression of SIRT1 protein among different tumor depths, Enneking stage, pathological types, and patients with or without Pulmonary Metastasis (P < 0.05). Among 40 SIRT1 positive patients, 13 survived, 27 died, the minimum total survival time was 2 months, the longest total survival time was 74 months. Among the 27 SIRT1 negative patients, 20 survived and 7 died. The minimum overall survival time was 5 months and the maximum overall survival time was 81 months. The Kaplan-Meier survival curve showed that the total survival time of SIRT1 positive subjects was significantly shorter than that of SIRT1 negative subjects (P < 0.05). The results of Log-rank test showed that there were significant differences in age, Enneking stage, expression of SIRT1 protein, pathological type, and survival prognosis of patients with or without pulmonary metastasis (P < 0.05). There was no significant difference in survival outcome among different sex, tumor size, location, and depth of tumor (P < 0.05). Cox stepwise regression model showed that the mortality risk of SIRT1 positive was 1.403 times higher than that of SIRT1 negative (P < 0.05).Conclusion The abnormal expression of SIRT1 protein may be related to the development, invasion, and metastasis of liposarcomas. SIRT1 protein is highly expressed not only in liposarcomas of limbs but also in lung metastases, with potential as a prognostic marker of limb liposarcomas.