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脂肪非典型钙黏蛋白4在胰腺癌组织中的表达水平及其与临床病理特征的关系
DOI: 10.3969/j.issn.1001-5256.2022.12.021
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摘要:
目的 研究脂肪非典型钙黏蛋白4(FAT4)在胰腺癌及其癌旁组织中的表达，分析其与临床病理特征的关系，探索FAT4在胰腺癌发生发展过程中所起的作用。 方法 收集郑州大学附属肿瘤医院2015年1月—2017年1月期间79例行根治性手术切除，且术后病理确诊为胰腺导管腺癌患者的胰腺癌组织及癌旁组织，采用免疫组化法检测FAT4蛋白在胰腺癌组织及癌旁组织中的表达, 并分析FAT4蛋白表达情况与临床病理特征的关系。等级资料组间比较采用Mann-Whitney U检验；计数资料组间比较采用χ2检验。相关性分析采用Spearman分析。 结果 FAT4蛋白在胰腺癌组织中低表达率为72.15%(52/79)，在癌旁组织中低表达率为21.52%(17/79)，差异有统计学意义(P＜0.001)。患者背痛在FAT4蛋白低表达和高表达间差异有统计学意义(χ2=4.115，P=0.042)。淋巴结转移、神经浸润在FAT4蛋白低表达与高表达间差异均有统计学意义(χ2值分别为8.743、4.925，P值分别为0.003、0.026)。Spearman相关分析结果显示FAT4蛋白表达与胰腺癌的TNM分期、分化程度无关(P值均＞0.05)。 结论 与癌旁组织相比，FAT4蛋白在胰腺癌组织中明显低表达，且与背痛症状、淋巴结转移及神经浸润的发生相关，提示FAT4可能与胰腺癌的发生发展相关。 Abstract:Objective To detect the expression of fat atypical cadherin 4 (FAT4) in pancreatic cancer tissue and para-carcinoma tissue, and explored the role of FAT4 in the pathogenesis of pancreatic cancer. Methods Pancreatic cancer tissue samples and adjacent tissue samples were collected from 79 patients who underwent radical resection in The Affiliated Cancer Hospital of Zhengzhou University from January 2015 to January 2017 and were diagnosed with pancreatic ductal adenocarcinoma based on postoperative pathology. Immunohistochemistry was used to measure the protein expression of FAT4 in pancreatic cancer tissue and adjacent tissue, and the association between FAT4 expression and clinicopathological features was analyzed. The Mann-Whitney U test was used for comparison of ranked data between groups, and the chi-square test was used for comparison of categorical data. A Spearman correlation analysis was used to investigate the correlation between variables. Results The down-regulated expression of FAT4 was detected in 72.15% (52/79) of pancreatic cancer tissue, which was significant higher than that in para-cancer tissues (21.52%, 17/79, P < 0.001). There was a significant difference in backache between the low FAT4 expression group and the high FAT4 expression group (χ2=4.115, P=0.042), and there were also significant differences in lymph node metastasis and perineural invasion between these two groups (χ2=8.743 and 4.925, P=0.003 and 0.026). TNM staging and degree of tumor differentiation were ranked variables, and the analysis of the association between these two variables and FAT4 expression based on Spearman rank correlation coefficient showed that FAT4 expression was not associated with the TNM staging and degree of tumor differentiation of pancreatic cancer (all P > 0.05). Conclusion The expression of FAT4 was significantly down-regulated in pancreatic cancer, suggesting that FAT4 may promote the invasion and infiltration of pancreatic cancer. -
Key words:
- Pancreatic Neoplasms /
- Immunohistochemistry /
- Pathology, Clinical
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图 1 FAT4蛋白在胰腺癌及癌旁组织中的表达情况(免疫组化，×200)
注：a，FAT4在胰腺癌组织中低表达；b，FAT4在胰腺癌组织中高表达；c，FAT4在癌旁组织中低表达；d，FAT4在癌旁组织中高表达。
Figure 1. Expression of FAT4 protein in pancreatic cancer tissue and para-carcinoma tissue(immunohistochemistry, ×200)
表 1 FAT4蛋白在胰腺癌和癌旁组织中的表达分布
Table 1. Distribution of FAT4 expression in pancreatic cancer tissue and para-carcinoma tissue
组别 例数 FAT4蛋白表达情况[例(%)] Z值 P值 - + ++ +++ 胰腺癌组织 79 38(48.10) 19(24.05) 22(27.85) 0 7.496 ＜0.001 癌旁组织 79 4(5.06) 13(16.45) 37(46.84) 25(31.65) 
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表 2 FAT4在胰腺癌和癌旁组织中的表达
Table 2. Expression of FAT4 protein in pancreatic cancer tissue and para-carcinoma tissue
组别 例数 FAT4低表达[例(%)] FAT4高表达[例(%)] χ2值 P值 胰腺癌组织 79 57(72.15) 22(27.85) 40.669 ＜0.001 癌旁组织 79 17(21.52) 62(78.48)
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表 3 FAT4蛋白表达与胰腺癌患者的一般临床情况
Table 3. Correlations between FAT4 expression and clinical features in pancreatic cancer patients
指标 例数 FAT4低表达 FAT4高表达 χ2值 P值 性别[例(%)] 0.494 0.482 男 48 36(75.00) 12(25.00) 女 31 21(67.74) 10(32.26) 年龄[例(%)] 0.603 0.438 ＜60岁 56 39(69.64) 17(30.36) ≥60岁 23 18(78.26) 5(21.74) 术前黄疸[例(%)] 3.250 0.071 有 61 41(67.21) 20(32.79) 无 18 16(88.89) 2(11.11) 背痛[例(%)] 4.115 0.042 有 36 30(83.33) 6(16.67) 无 43 27(62.79) 16(37.21) 术前空腹血糖[例(%)] 1.566 0.211 正常 45 30(66.67) 15(33.33) 升高 34 27(79.41) 7(20.59)
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表 4 FAT4蛋白表达与临床病理特征的关系
Table 4. Correlations between FAT4 expression and clinicopathological characteristics in pancreatic cancer patients
病理学特征 例数 FAT4低表达[例(%)] FAT4高表达[例(%)] χ2值 P值 肿瘤位置 0.029 0.864 胰头 60 46(76.67) 14(23.33) 胰体尾 19 11(57.89) 8(26.32) 肿瘤大小 2.688 0.101 ≤4 cm 54 42(77.78) 12(22.23) ＞4 cm 25 15(60.00) 10(40.00) 淋巴结转移 8.743 0.003 有 46 39(84.78) 7(15.22) 无 33 18(54.55) 15(45.45) 神经侵犯 4.925 0.026 有 41 34(82.93) 7(17.07) 无 38 23(60.53) 15(39.47) 分化程度 4.866 0.088 高分化 15 8(53.33) 7(46.67) 中分化 42 30(71.43) 12(28.57) 低分化 22 19(86.36) 3(13.64) TNM分期 1.913 0.384 Ⅰ期 24 15(62.50) 9(37.50) Ⅱ期 49 38(77.55) 11(22.45)
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表 5 FAT4蛋白表达与TNM分期的关系
Table 5. Correlations between FAT4 expression and TNM stage
TNM分期 例数 FAT4表达水平[例(%)] r值 P值 - + ++ +++ Ⅰ期 24 6(25.00) 9(37.50) 9(37.50) 0 Ⅱ期 49 29(59.18) 9(18.37) 11(22.45) 0 0.344 0.365 Ⅲ期 6 3(50.00) 1(16.67) 2(33.33) 0 Ⅳ期 0 0 0 0 0
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表 6 FAT4蛋白表达与肿瘤组织学类型的关系
Table 6. Correlations between FAT4 expression and TNM stage
组织学分级 例数 FAT4表达水平[例(%)] r值 P值 - + ++ +++ 高分化 15 3(20.00) 5(33.33) 7(46.67) 0 中分化 42 15(35.71) 15(35.71) 12(28.57) 0 0.305 0.424 低分化 22 16(72.73) 3(13.64) 3(13.64) 0
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