半乳糖凝集素-9和音猬因子表达检测在结直肠癌早期诊断及预后中的作用

何倩; 刘昕; 林甜甜; 董笑楠

doi:10.12182/20260160603

半乳糖凝集素-9和音猬因子表达检测在结直肠癌早期诊断及预后中的作用

Role of Galectin-9 and Sonic Hedgehog Expressions in the Early Diagnosis and Prognosis of Colorectal Cancer

摘要

摘要:
目的观察结直肠癌患者癌组织中半乳糖凝集素-9（galectin-9）和音猬因子（sonic hedgehog，SHH）的表达变化，分析二者与结直肠癌发生风险及预后的关联。
方法回顾性纳入2020年5月–2022年5月青岛市中医医院收治的结直肠癌患者210例，检测其癌组织及癌旁组织中galectin-9与SHH的表达水平。采用logistic回归分析两者表达与结直肠癌发病风险之间的关系，并绘制受试者工作特征（receiver operating characteristic, ROC）曲线，评估二者对结直肠癌发病风险及预后的预测价值。
结果与癌旁组织相比，癌组织中galectin-9和SHH的表达水平差异均有统计学意义（P<0.05）。ROC曲线分析显示，galectin-9和SHH表达水平评估结直肠癌发生风险的曲线下面积（area under the curve，AUC）分别为0.809（95% CI：0.751～0.868）和0.865（95% CI：0.817～0.912）。在T_3-4、N_1-3、M₁及低分化患者中galectin-9表达降低（P<0.05），而SHH表达水平则升高（P<0.05）。Galectin-9与SHH表达及TNM分期呈负相关（r=−0.184、−0.362，P<0.001）；SHH表达与TNM分期正相关（r=0.407，P<0.001）。预后不良与预后良好患者galectin-9、SHH表达水平比较差异有统计学意义（P<0.05）。Logistic回归分析显示，T_3-4期（OR=4.609，95%CI：1.461～14.535）、低分化（OR=3.337，95%CI：1.297～8.582）及SHH（OR=2.067，95%CI：1.162～3.678）水平为影响患者预后的危险因素（P<0.05），galectin-9（OR=0.652，95%CI：0.437～0.975）为影响患者预后的保护因素（P<0.05）。ROC曲线显示，galectin-9、SHH表达水平评估结直肠癌预后的AUC分别为0.769（95% CI：0.550～0.798）和0.734（95% CI：0.603～0.866）。
结论 Galectin-9、SHH在结直肠癌患者中分别呈低表达和高表达，其表达水平与肿瘤的低分化、侵袭和转移行为有关，且对患者患病风险和预后具有一定的评估价值。

Abstract:
Objective To investigate the association between the expression levels of galectin-9 and sonic hedgehog (SHH) and the risk of occurrence and prognosis in patients with colorectal cancer (CRC).
Methods A total of 210 patients with CRC treated at Qingdao Traditional Chinese Medicine Hospital between May 2020 and May 2022 were retrospectively included. The expressions of galectin-9 and SHH in tumor tissues were measured. Logistic regression was used to analyze the relationship between galectin-9/SHH expression and CRC risk. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of galectin-9 and SHH for CRC risk and prognosis.
Results The expression levels of galectin-9 and SHH differed significantly between cancer tissues and adjacent normal tissues (P<0.05). ROC analysis showed that the AUCs for galectin-9 and SHH in evaluating CRC risk were 0.809 (95% CI: 0.751-0.868) and 0.865 (95% CI: 0.817-0.912), respectively. Galectin-9 expression was lower in patients with T_3-4 stage, N_1-3 stage, M₁ stage, or poor differentiation (P<0.05), whereas SHH expression was higher in these patients(P<0.05). Galectin-9 expression was negatively correlated with SHH expression and TNM stage (r=−0.184 and −0.362, respectively; P<0.001). SHH expression was positively correlated with TNM stage (r = 0.407, P< 0.001). Significant differences in galectin-9 and SHH expression were observed between patients with poor prognosis and those with good prognosis (P< 0.05). Logistic regression analysis indicated that T_3-4 stage (OR= 4.609, 95% CI: 1.461-14.535), poor differentiation (OR=3.337, 95% CI: 1.297-8.582), and high SHH expression (OR= 2.067, 95% CI: 1.162-3.678) were risk factors for poor prognosis (P< 0.05), while high galectin-9 expression (OR = 0.652, 95% CI: 0.437-0.975) was a protective factor (P< 0.05). The AUCs of galectin-9 and SHH for evaluating CRC prognosis were 0.769 (95% CI: 0.550-0.798) and 0.734 (95% CI: 0.603-0.866), respectively.
Conclusion Galectin-9 and SHH are lowly and highly expressed, respectively, in CRC. Their expression levels are associated with tumor differentiation, invasion, and metastasis, and hold predictive value for the risk and prognosis of CRC patients.

HTML全文

参考文献(30)

施引文献

资源附件(0)