[1]朱军,沈欣,曹冬.非肌层浸润性膀胱癌组织中PKM2 和ALYREF 表达及与预后预测价值研究[J].现代检验医学杂志,2023,38(05):110-114+154.[doi:10.3969/j.issn.1671-7414.2023.05.021]
　ZHU Jun,SHEN Xin,CAO Dong.Expression of PKM2 and ALYREF in Non-muscular Invasive Bladder Cancer and Their Prognostic Value[J].Journal of Modern Laboratory Medicine,2023,38(05):110-114+154.[doi:10.3969/j.issn.1671-7414.2023.05.021]
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非肌层浸润性膀胱癌组织中PKM2 和ALYREF 表达及与预后预测价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年05期
页码:
110-114+154
栏目:
论著
出版日期:
2023-09-15

文章信息/Info

Title:
Expression of PKM2 and ALYREF in Non-muscular Invasive Bladder Cancer and Their Prognostic Value
文章编号:
1671-7414（2023）05-110-06
作者:
朱军; 沈欣; 曹冬
（江苏省靖江市中医院/ 南京中医药大学翰林学院附属医院泌尿外科，江苏靖江 214500）
Author(s):
ZHU Jun;  SHEN Xin;  CAO Dong
（Department of Urology Surgery, Jingjiang City Hospital of Traditional Chinese Medicine Affiliated Hospital of Hanlin College of Nanjing University of Chinese Medicine , Jiangsu Jingjiang 214500, China）
关键词:
非肌层浸润膀胱癌; 丙酮酸激酶M2 亚型; RNA 结合蛋白Aly/REF 输出因子
分类号:
R737.14；R730.43
DOI:
10.3969/j.issn.1671-7414.2023.05.021
文献标志码:
A
摘要:
目的 研究非肌层浸润性膀胱癌（non-muscle invasive bladder cancer ，NMIBC）组织中丙酮酸激酶M2 亚型(pyruvate kinase M2 subtype ，PKM2)，RNA 结合蛋白Aly/REF 输出因子(Aly/REF export factor，ALYREF) 表达及预后意义。方法 选取自2017 年2 月～ 2020 年2 月期间南京中医药大学翰林学院附属医院收治的84 例NMIBC 患者为研究对象。免疫组织化学检测NMIBC 和膀胱正常黏膜组织中PKM2 和ALYREF 蛋白表达。Spearman 秩相关分析膀胱癌组织中PKM2 和ALYREF 蛋白表达相关性。Kaplan-Meier 生存曲线分析（Log-Rank 检验）PKM2 和ALYREF 蛋白对无进展生存（progress free survive, PFS）预后的影响。COX 比例风险模型分析影响NMIBC 患者PFS 预后的因素。结果 NMIBC 组织中PKM2(71.43%），ALYREF(73.81%）蛋白阳性率高于膀胱正常黏膜组织（11.90%，10.71%），差异具有统计学意义（χ2=61.225，68.522, 均P <0.05）。T1 期、高级别NMIBC 癌组织中PKM2(88.37%，90.32%），ALYREF(80.05%，93.55%）蛋白阳性率分别高于Ta/Tis 期（53.66%，60.38%）、低级别癌组织（60.98%，62.26%），差异具有统计学意义(χ2=12.393，8.594；6.524，9.903，均P ＜ 0.05）。PKM2 阳性组和阴性组患者的三年总体PFS 分别为48.33%（29/60），87.50%（21/24），PKM2 阳性组患者三年累积PFS 显著低于PKM2 阴性组患者（Log-Rank testχ2=10.040，P=0.002）；ALYREF 阳性组和阴性组三年总体PFS 分别为48.39%（30/62），90.91%（20/22），ALYREF 阳性组患者三年累积PFS 显著低于阴性组患者（Log-Rank testχ2=11.110，P=0.001）。肿瘤TNM 分期T1 期(HR=1.614，95%CI: 1.227 ～ 2.214)、高级别(HR=1.921，95%CI: 1.324 ～ 2.788)，PKM2 阳性(HR=1.837，95%CI: 1.229 ～ 2.745)，ALYREF 阳性(HR=1.744，95%CI: 1.245 ～ 2.443) 是影响NMIBC 患者PFS 预后的独立危险因素。结论 NMIBC 中PKM2 和ALYREF 表达升高，两者表达呈正相关，是影响NMIBC 患者预后的独立因素。
Abstract:
Objective To study the expression of pyruvate kinase M2 subtype (PKM2)，RNA binding protein Aly/REF output factor (ALYREF) and their prognostic significance in non-muscle invasive bladder cancer (NMIBC). Methods 84 patients with NMIBC admitted to Nanjing University of Chinese Medicine Hanlin College from February 2017 to February 2020 were selected as the study subjects. Immunohistochemistry was used to detect the expression of PKM2 and ALYREF protein in NMIBC and normal bladder mucosa tissues. Spearman rank correlation analysis of PKM2 and ALYREF protein expression in bladder cancer tissue. Kaplan-Meier survival curve analysis (Log-Rank test) was used to analyze the effect of PKM2 and ALYREF protein on the prognosis of progression-free survival (PFS). COX proportional risk model was used to analyze the factors affecting the prognosis of PFS in patients with NMIBC. Results The positive rate of PKM2 (71.43%) and ALYREF (73.81%) protein in NMIBC bladder cancer tissue was higher than that in normal bladder mucosa tissue（11.90%，10.71%）, with statistical significance（χ2=61.225, 68.522, all P<0.05). The positive rates of PKM2 (88.37% ，90.32%) and ALYREF (80.05% ，93.55%) protein in T1 and high-grade NMIBC cancer tissues were higher than those in Ta/Tis（53.66%，60.38%）and low-grade cancer tissues（60.98%，62.26%）, and the differences were statistically significant（χ2=12.393，8.594；6.824，9.903，all P<0.05).The 3-year total PFS of PKM2 positive group and negative group were 48.33% (29/60) and 87.50% (21/24) respectively. The cumulative PFS of patients in the PKM2 positive group in 3 years was significantly lower than that of patients in the PKM2 negative group (Log-Rank test χ2=10.040，P=0.002）. The overall PFS of ALYREF positive group and negative group in 3 years were 48.39% (30/62) and 90.91% (20/22) respectively. The cumulative PFS of patients in the ALYREF positive group in 3 years was significantly lower than that of patients in the negative group (Log-Rank test χ2=11.110，P=0.001）. Tumor TNM stage T1 (HR=1.614,95% CI: 1.227~2.214), high grade (HR=1.921,95% CI: 1.324~2.788), PKM2 positive (HR=1.837,95% CI: 1.229~2.745), and ALYREF positive (HR=1.744,95% CI: 1.245~2.443) were independent risk factors affecting the prognosis of PFS in patients with NMIBC. Conclusion The expression of PKM2 and ALYREF in NMIBC were increased, and there was a positive correlation between them, which are independent factors affecting the prognosis of NMIBC patients.

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备注/Memo

备注/Memo:
基金项目： 江苏省卫生健康委医学科研立项项目（课题编号：BJ20021）：PKM2 与ALYREF 非肌层浸润性膀胱癌组织中表达及预后的相关性研究。
作者简介：朱军（1975-），男，硕士，副主任医师，研究方向：泌尿系统肿瘤，E mail:zhujun19751101@163.com。
通讯作者：沈欣，男，硕士，副主任医师，研究方向：泌尿系统肿瘤，E mail：shenxin1128@126.com。
更新日期/Last Update: 2023-09-15