鼻咽癌组织中SP、NK-1R表达与临床病理特征及预后的关系

Relationship of expression of SP and NK-1R in nasopharyngeal carcinoma with clinicopathological factors and prognosis

摘要:

目的 探讨鼻咽癌组织中P物质（SP）、神经激肽-1（NK-1R）表达与临床病理特征及预后的关系。方法 选取2016年4月—2018年11月郴州市第一人民医院收治的83例鼻咽癌患者为研究组，另选取同期行鼻中隔偏曲矫正术患者（经病理证实鼻咽黏膜组织正常）47例为对照组。研究组所有患者治疗后随访3年。采用实时荧光定量聚合酶链反应（qRT-PCR）检测鼻咽癌组织、正常鼻咽黏膜组织中SP、NK-1R mRNA相对表达量；采用免疫组织化学法检测鼻咽癌组织、正常鼻咽黏膜组织中SP、NK-1R蛋白的表达；比较研究组不同临床病理特征患者鼻咽癌组织中SP、NK-1R蛋白的阳性表达率；采用Cox回归分析影响鼻咽癌患者治疗后复发或转移的因素；采用Kaplan-Meier法绘制生存曲线，分析癌组织中SP、NK-1R蛋白表达与鼻咽癌患者无病生存的关系。结果 研究组鼻咽癌组织中SP、NK-1R mRNA相对表达量均高于对照组正常鼻咽黏膜组织（P <0.05）。研究组鼻咽癌组织中SP、NK-1R蛋白阳性表达率均高于对照组正常鼻咽黏膜组织（P <0.05）。研究组T₃、T₄期的鼻咽癌组织中SP阳性表达率高于T₁、T₂期者（P <0.05），研究组M₁期、Ⅲ~Ⅳa期的鼻咽癌组织中SP、NK-1蛋白阳性表达率分别高于M₀期、Ⅰ、Ⅱ期者（P <0.05）。83例鼻咽癌患者随访结束有8例失访。Cox回归分析显示：M分期［R^R=4.958（95% CI：2.040，12.050）］、临床分期［R^R=6.593（95% CI：2.713，16.023）］、SP阳性［R^R=4.063（95% CI：1.672，9.875）］、NK-1R阳性［R^R=4.047（95% CI：1.665，9.836）］是影响鼻咽癌患者治疗后复发或转移的危险因素（P <0.05）。43例SP阳性表达患者无病生存34例，32例SP阴性表达患者无病生存31例；SP阴性表达患者的无病生存率高于阳性表达患者（P <0.05）。随访3年38例NK-1R阳性表达患者无病生存29例，37例NK-1R阴性表达患者无病生存36例；NK-1R阴性表达患者的无病生存率高于阳性表达患者（P <0.05）。结论 鼻咽癌患者癌组织中SP、NK-1R蛋白表达与临床病理特征及预后有关，SP、NK-1R阳性表达患者复发转移风险高。

Abstract:

Objective To investigate the relationship of the expressions of substance P (SP) and neurokinin-1 (NK-1R) in nasopharyngeal carcinoma tissues with clinicopathological factors and prognosis.Methods A total of 83 patients with nasopharyngeal carcinoma who were admitted to the hospital from April 2016 to November 2018 were selected as the research group, and 47 patients who underwent nasal septum deviation correction in the hospital during the same period (with normal nasopharyngeal mucosal tissue confirmed by pathology) were selected as the control group. All patients in the study group were followed up for 3 years after treatment. The expressions of SP and NK-1R in nasopharyngeal carcinoma tissues and normal nasopharyngeal mucosa tissues were detected by real-time fluorescence quantitative PCR and immunohistochemistry. The expressions of SP and NK-1R in nasopharyngeal carcinoma tissues and normal nasopharyngeal mucosa tissues were compared. The relationship of SP, NK-1R expression with clinicopathological parameters in cancer tissues of patients with nasopharyngeal carcinoma was analyzed. To analyze the factors affecting the recurrence or metastasis of nasopharyngeal carcinoma patients after treatment. The relationship of SP and NK-1R protein expression in cancer tissue with disease-free survival of patients with nasopharyngeal carcinoma was analyzed.Results The relative expressions of SP and NK-1R mRNA in nasopharyngeal carcinoma tissues were higher than those in normal nasopharyngeal mucosa tissues (P < 0.05). The positive expression rates of SP and NK-1R in nasopharyngeal carcinoma tissues were higher than those in normal nasopharyngeal mucosa tissues (P < 0.05). The positive expression rates of SP and NK-1 in cancer tissues of patients with M₁ and Ⅲ to Ⅳa nasopharyngeal carcinoma were higher than those of M₀ and Ⅰ to Ⅱ stages (P < 0.05), and those of T₃ to T₄ nasopharyngeal carcinoma The positive expression rate of SP in tissues was higher than that in T₁ to T₂ stage (P < 0.05). Of the 83 patients with nasopharyngeal carcinoma, 8 were lost to follow-up at the end of follow-up. Cox regression analysis showed: M stage [R^R = 4.958, (95% CI: 2.040, 12.050) ], clinical stage [R^R = 6.593 (95% CI: 2.713, 16.023) ], SP positive [R^R= 4.063 (95% CI: 1.672, 9.875) ], NK-1R positive [R^R = 4.047 (95% CI: 1.665, 9.836) ] were risk factors affecting the recurrence or metastasis of NPC patients after treatment (P < 0.05). Among the 43 SP-positive patients, 34 had disease-free survival, and 32 SP-negative patients had a disease-free survival of 31. The disease-free survival curve of SP negative expression patients was better than patients with SP positive expression (P < 0.05). 29 of 38 patients with positive NK-1R expression and 36 of 37 patients with negative expression of NK-1R. The disease-free survival curve of patients with negative NK-1R expression was better than patients with positive expression (P < 0.05).Conclusion The expression of SP and NK-1R proteins in cancer tissues of patients with nasopharyngeal carcinoma is related to clinicopathological parameters and prognosis. Patients with positive expression of SP and NK-1R have a high risk of recurrence and metastasis.