国际医药卫生导报 ›› 2024, Vol. 30 ›› Issue (6): 903-907.DOI: 10.3760/cma.j.issn.1007-1245.2024.06.004

• 专题:肺癌 • 上一篇    下一篇

非小细胞肺癌组织中CLCA4的表达情况及与病理和预后的关系

吴媛媛1  刘科1  齐艳丽2  童小华1   

  1. 1商洛市中心医院病理科,商洛 726000;2商洛市中心医院呼吸与危重症医学科,商洛 726000

  • 收稿日期:2023-12-12 出版日期:2024-03-01 发布日期:2024-03-29
  • 通讯作者: 童小华,Email:yangyan_jian@163.com
  • 基金资助:

    陕西省自然科学基础研究计划(2023-JC-QN-0840)

Expression of CLCA4 in non-small cell lung cancer tissue and its correlations with pathology and prognosis

Wu Yuanyuan1, Liu Ke1, Qi Yanli2, Tong Xiaohua1   

  1. 1 Department of Pathology, Shangluo Central Hospital, Shangluo 726000, China; 2 Department of Respiratory and Critical Care Medicine, Shangluo Central Hospital, Shangluo 726000, China

  • Received:2023-12-12 Online:2024-03-01 Published:2024-03-29
  • Contact: Tong Xiaohua, Email: yangyan_jian@163.com
  • Supported by:

    Shaanxi Province Natural Science Basic Research Program (2023-JC-QN-0840)

摘要:

目的 探究非小细胞肺癌(NSCLC)癌组织中钙激活的氯离子通道A4(CLCA4)的表达情况及其与病理和预后的关系。方法 前瞻性选取2019年4月至2022年4月商洛市中心医院收治的106例NSCLC患者进行研究,其中男性64例,女性42例,年龄(56.53±7.54)岁。均行NSCLC根治性切除术,术后采用免疫组化法检测癌组织及癌旁正常组织中CLCA4的阳性表达情况,采用实时荧光定量逆转录聚合酶链反应(qRT-PCR)检测癌组织及癌旁正常组织中CLCA4 mRNA的相对表达量。根据患者1年随访结局分为无病生存(DFS)组(48例)和非DFS组(58例)。采用t检验和χ2检验对数据进行统计学分析,采用多因素logistic逐步回归模型、生存曲线Kaplan-Meier分析与对数秩检验对患者预后的影响因素进行分析,绘制受试者操作特征曲线(ROC)分析CLCA4与病理和预后的关系。结果 癌组织中CLCA4阳性率[45.28%(48/106)]及CLCA4 mRNA的相对表达量[(0.61±0.14)]均低于癌旁正常组织[66.98%(71/106)、(1.07±0.23)](χ2=10.134,P<0.001;t=17.589,P<0.001)。Ⅱ期患者的CLCA4 mRNA表达量高于ⅢA期患者[(0.69±0.15)比(0.61±0.13)](t=2.914,P=0.004)。非DFS组患者中ⅢA期的占比高于DFS组[82.76%(48/58)比33.33%(16/48)](χ2=26.819,P<0.001),CLCA4 mRNA表达量低于DFS组[(0.54±0.13)比(0.69±0.17)](t=5.514,P<0.001)。TNM分期(OR=4.031,95%CI 1.429~11.364,P=0.003)、CLCA4 mRNA表达量(OR=0.310,95%CI 0.109~0.873,P=0.003)是NSCLC患者DFS的影响因素。CLCA4 mRNA表达预测NSCLC患者DFS的灵敏度为0.802(95%CI 0.715~0.893)、特异度为0.809(95%CI 0.721~0.904)、曲线下面积(AUC)为0.857(95%CI 0.782~0.935)。不同CLCA4 mRNA表达组患者的生存曲线比较,差异有统计学意义(Log-rank χ2=6.006,P=0.014)。结论 NSCLC患者癌组织中CLCA4表达被抑制,且与病理进展及预后有关。

关键词:

非小细胞肺癌, 钙激活的氯离子通道A4, 病理, 预后

Abstract:

Objective To investigate the expression of calcium-activated chloride channel regulator 4 (CLCA4) in non-small cell lung cancer (NSCLC) tumor tissues and its correlations with pathology and prognosis. Methods A total of 106 patients with NSCLC admitted to Shangluo Central Hospital from April 2019 to April 2022 were prospectively selected for the study, including 64 males and 42 females, aged (56.53±7.54) years. All the patients underwent radical resection of NSCLC. The positive expression of CLCA4 in cancer tissues and adjacent normal tissues was detected by immunohistochemistry, and the relative expression of CLCA4 mRNA in cancer tissues and adjacent normal tissues was detected by real-time fluorescent quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). The patients were divided into a progression-free survival (DFS) group and a non-DFS group according to the 1-year follow-up outcomes. t test and χ2 test were used for statistical analysis. Multivariate logistic stepwise regression model, Kaplan-Meier survival curve analysis, and log-rank test were used to analyze the patients' prognostic factors. The receiver operating characteristic curve (ROC) was drawn to analyze the relationships between CLCA4 and pathology and prognosis. Results The positive rate of CLCA4 [45.28% (48/106)] and the relative expression level of CLCA4 mRNA [(0.61±0.14)] in cancer tissues were lower than those in adjacent normal tissues [66.98% (71/106) and (1.07±0.23)] (χ2=10.134, P<0.001; t=17.589, P<0.001). The expression level of CLCA4 mRNA in stage Ⅱ patients was higher than that in stage ⅢA patients [(0.69±0.15) vs. (0.61±0.13)] (t=2.914, P=0.004). The proportion of stage ⅢA in the non-DFS group was higher than that in the DFS group [82.76% (48/58) vs. 33.33% (16/48)] (χ2=26.819, P<0.001), and the expression of CLCA4 mRNA was lower than that in the DFS group [(0.54±0.13) vs. (0.69±0.17)] (t=5.514, P<0.001). TNM stage (OR=4.031, 95%CI 1.429-11.364, P=0.003) and CLCA4 mRNA expression level (OR=0.310, 95%CI 0.109-0.873, P=0.003) were the influencing factors for DFS in NSCLC patients. The sensitivity of CLCA4 mRNA expression in predicting DFS in NSCLC patients was 0.802 (95%CI 0.715-0.893), the specificity was 0.809 (95%CI 0.721-0.904), and the area under the curve (AUC) was 0.857 (95%CI 0.782-0.935). The survival curves of the patients in different CLCA4 mRNA expression groups were significantly different (Log-rank χ2=6.006, P=0.014). Conclusion The expression of CLCA4 in cancer tissue of NSCLC patients is suppressed, which is related to pathological progression as well as prognosis.

Key words:

Non-small cell lung cancer, Calcium-activated chloride channel regulator 4, Pathology, Prognosis