上皮-间充质转化标志物SNAI1/ZEB1/ZEB2/CDH2表达与老年胃癌患者预后相关性分析

Correlation analysis of expression of epithelial-mesenchymal transition markers(SNAI1,ZEB1,ZEB2 and CDH2)and prog-nosis in elderly patients with gastric cancer

中文关键词: 老年  胃癌  预后  上皮-间充质转化  列线图  病理分期  危险因素

英文关键词: elderly  gastric cancer  prognosis  epithelial-mesenchymal transition  nomogram  pathological stage  risk factor

中文摘要:

      目的 探索上皮-间充质转化(EMT)标志物SNAI1、ZEB1、ZEB2、CDH2表达与老年胃癌患者预后的相关性.方法 回顾性纳入2018年1月—2023年12月在南京市栖霞区医院确诊的93例老年胃癌患者.采用酶联免疫吸附法检测(ELISA)患者胃癌组织中SNAI1、ZEB1、ZEB2、CDH2蛋白的表达,并依据最佳截断值将患者分为各EMT标志物的高表达组和低表达组.主要研究终点为总生存期(OS).采用单因素和多因素COX回归分析筛选独立预后危险因素,建立列线图模型;采用校准曲线评估预测效能;采用K-M曲线和Log-rank检验进行生存分析.结果 SNAI1高表达组的预后优于SNAI1低表达组,ZEB1低表达组预后优于ZEB1高表达组,ZEB2低表达组预后优于ZEB2高表达组,CDH2低表达组的预后优于CDH2高表达组,差异均有统计学意义(P＜0.05).单因素COX分析结果表明,病理分期、T分期、N分期、ZEB1和CDH2是胃癌预后不良的危险因素(HR＞1,P＜0.05);多因素COX分析结果表明,病理分期、ZEB1和CDH2是胃癌预后不良的独立危险因素(HR＞1,P＜0.05);T分期和N分期与胃癌预后无显著相关性(P＞0.05).基于独立危险因素,构建胃癌患者预后预测模型.校准曲线表明,列线图预测模型的1年、2年预测生存率均接近实际生存率,列线图预测效能较好.结论 病理分期、ZEB1和CDH2是老年胃癌患者预后不良的独立危险因素,以此构建的列线图模型具有较好的预测效能.

英文摘要:

      Objective To explore the correlation between the expression of epithelial-mesenchymal transition(EMT)markers(SNAI1,ZEB1,ZEB2 and CDH2)and the prognosis in elderly patients with gastric cancer.Methods A total of 93 elderly patients with gastric cancer diagnosed in Qixia District Hospital from January 2018 to December 2023 were retrospective-ly included.Enzyme-linked immunosorbent assay(ELISA)was used to detect protein expression levels of SNAI1,ZEB1,ZEB2 and CDH2 in gastric cancer tissues.Based on optimal cutoff values,patients were divided into high-expression groups and low-expression groups for each EMT marker.The primary endpoint of the study was overall survival(OS).Univariate and multivariate Cox regression analyses were used to identify independent prognostic risk factors and a nomogram model was con-structed.Calibration curve was employed to evaluate predictive accuracy,and Kaplan-Meier curve and log-rank tests were used for survival analysis.Results The prognosis of the SNAI1 high-expression group was better than that of the SNAI1 low-ex-pression group.The prognosis of the ZEB1 low-expression group was better than that of the ZEB1 high-expression group.The prognosis of the ZEB2 low-expression group was better than that of the ZEB2 high-expression group.The prognosis of the CDH2 low-expression group was better than that of the CDH2 high-expression group.The differences were all statistically sig-nificant(P＜0.05).Univariate Cox analysis indicated that pathological stage,T stage,N stage,ZEB1,and CDH2 were risk factors for poor prognosis in elderly gastric cancer patients(HR＞1,P＜0.05).Multivariate Cox analysis confirmed that path-ological stage,ZEB1 and CDH2 were independent risk factors for poor prognosis in elderly gastric cancer patients(HR＞1,P＜0.05),while T stage and N stage showed no significant correlation with prognosis(P＞0.05).Based on these independ-ent risk factors,a prognostic prediction model for gastric cancer patients was constructed.The calibration curve indicated that the 1-year and 2-year predicted survival rates of the nomogram prediction model were both close to the actual survival rates,demonstrating a good predictive performance of the nomogram.Conclusion Pathological stage,ZEB1 and CDH2 are inde-pendent risk factors for poor prognosis in elderly gastric cancer patients.The constructed nomogram model exhibits high predic-tive efficacy.