胶质瘤患者层粘连蛋白γ1、玻连蛋白的表达及其临床意义

Expression and clinical implications of laminin subunit gamma-1 and vitronectin in glioma patients

摘要:

目的 研究胶质瘤患者层粘连蛋白γ1（LAMC1）、玻连蛋白（VTN）的表达及临床意义。方法 选取2021年2月—2023年7月海军特色医学中心收治的109例胶质瘤患者作为研究组，另取同期该院45例脑部外伤手术患者作为对照组。随访1年，根据胶质瘤患者预后分为死亡组与生存组。采用免疫组织化学法检测LAMC1表达水平，酶联免疫吸附试验检测血清VTN水平。采用多因素Cox回归模型分析胶质瘤患者预后的影响因素，绘制Kaplan-Meier生存曲线分析LAMC1、VTN表达与胶质瘤患者1年生存率的关系。结果 研究组LAMC1、VTN水平均高于对照组（P <0.05）。LAMC1高表达组肿瘤直径≥ 5 cm、临床分期Ⅲ、Ⅳ期及Karnofsky功能状态（KPS）评分< 70分的患者构成均高于LAMC1低表达组（P <0.05）。VTN高表达组肿瘤直径≥ 5 cm、临床分期Ⅲ、Ⅳ期和KPS评分< 70分的患者构成均高于VTN低表达组（P <0.05）。随访1年，所有胶质瘤患者均未失访，其中死亡63例，生存46例。LAMC1高表达与低表达患者的生存曲线比较，差异有统计学意义（P <0.05）。VTN高表达与低表达患者的生存曲线比较，差异有统计学意义（P <0.05）。多因素逐步Cox回归分析结果：LAMC1高表达［H^R=3.425（95% CI：1.505，7.790）］、VTN高表达［H^R=2.798（95% CI：1.230，6.366）］均为胶质瘤患者1年内死亡的危险因素（P <0.05）。结论 胶质瘤组织中LAMC1高表达、血清VTN高表达，其表达与肿瘤直径、临床分期、KPS评分及1年预后有关，且两者均可作为胶质瘤患者预后评估的生物学标志物。

Abstract:

Objective To investigate the expression and clinical implications of laminin subunit gamma-1 (LAMC1) and vitronectin (VTN) in glioma patients.Methods A total of 109 patients with glioma treated in our hospital from February 2021 to July 2023 were selected as the study group, and 45 patients with brain trauma treated in the hospital during the same period were selected as the control group. Patients with glioma were followed up for 1 year and divided into the death group and the survival group according to the prognosis. The expression level of LAMC1 was detected by immunohistochemistry and serum VTN was determined by enzyme-linked immunosorbent assay. Multivariable Cox regression was used to analyze the prognostic factors of glioma patients, and Kaplan-Meier curve was drawn to determine the relationship between LAMC1 and VTN expressions and the 1-year survival rate of glioma patients.Results The levels of LAMC1 and VTN in the study group were higher than those in the control group (P < 0.05). The proportion of patients with tumor diameter ≥ 5 cm, clinical stage III-IV, and Karnofsky Performance Status (KPS) score < 70 was significantly higher in the high LAMC1 expression group compared to the low expression group (P < 0.05). The proportion of patients with tumor diameter ≥ 5 cm, clinical stage III-IV, and KPS score < 70 was higher in the high VTN expression group compared to the low expression group (P < 0.05). After 1 year of follow-up, all glioma patients were not lost to follow-up. Among them, 63 died and 46 survived. The survival curves of patients with high versus low LAMC1 expression were compared, showing a statistically significant difference (P < 0.05). The survival curve of patients with high expression of VTN was also significantly different than that of patients with low expression of VTN (P < 0.05). The multivariable stepwise Cox regression analysis demonstrated that high LAMC1 expression [H^R = 3.425 (95% CI: 1.505, 7.790) ] and high VTN expression [H^R = 2.798 (95% CI: 1.230, 6.366) ] were both risk factors for death within 1 year in glioma patients (P < 0.05).Conclusion LAMC1 and VTN are highly expressed in glioma tissues and are associated with tumor size, WHO stage, KPS score, and 1-year prognosis. Both of them may serve as potential biomarkers for prognostic assessment.