摘要：

目的： 探讨黏蛋白4（mucin 4, MUC4）在口腔鳞状细胞癌（oral squamous cell carcinoma, OSCC）组织中的表达，以及其对患者预后的影响。方法： 选取2012年7月—2015年7月间在我院接受手术治疗的89例OSCC患者的样本，采用免疫组织化学链霉菌抗生物素蛋白-过氧化物酶连结法（streptavidin-perosidase, SP）检测OSCC组织和癌旁组织中MUC4蛋白的表达。于术后开始随访，随访截至2020年7月31日，随访终止事件为患者死亡或者随访满5年，记录患者生存时间和5年生存率。使用Kaplan-Meier法进行生存曲线分析，应用log-rank检验对患者5年生存率进行比较，使用多因素Cox比例风险模型分析影响患者生存时间的相关因素。结果： MUC4蛋白在OSCC组织中的阳性率为73.03%，高于癌旁组织的20.22%，差异有统计学意义（χ²=49.867，P<0.001）；MUC4蛋白在TNM分期Ⅲ~Ⅳ期，低分化、中分化及发生淋巴结转移的OSCC患者中的阳性表达率高于其在Ⅰ~Ⅱ期、高分化及未发生淋巴结转移的OSCC患者中，差异有统计学意义（P<0.01）；MUC4蛋白阴性表达组患者平均生存时间为（47.00±3.35）个月，5年生存率为58.33%，均高于阳性表达组[（24.94±2.40）个月和20.00%]，log-rank检验差异有统计学意义（χ²=15.358，P<0.001）；TNM分期、分化程度、淋巴结转移和MUC4蛋白表达水平是影响OSCC患者生存时间的独立风险因素（P<0.05）。结论： MUC4蛋白在OSCC患者组织中呈高表达，且与TNM分期、分化程度和淋巴结转移相关，可能是评估患者预后的潜在生物学标志物。

关键词: 口腔鳞状细胞癌, 黏蛋白4, 免疫组织化学, 临床指标, Cox比例风险模型

Abstract:

Objective: To investigate the expression of mucin 4(MUC4) in oral squamous cell carcinoma(OSCC) tissues and the significance on the prognosis of patients. Methods: Samples from 89 patients with OSCC who underwent surgical treatment from July 2012 to July 2015 in our hospital were selected. The expression of MUC4 protein in OSCC and adjacent tissues was detected by streptavidin-perosidase (SP) immunohistochemistry. The patients were followed up after operation until July 31. 2020. The end of follow-up event was the death of the patient or the follow-up up to 5 years. The survival time and 5-year survival rate of the patients were recorded. The Kaplan-Meier method was used to analyze the survival curve. The log-rank test was used to compare the 5-year survival rate. And the multivariate Cox proportional hazard model was used to analyze the relevant factors affecting the survival time of patients. Results: The positive expression rate of MUC4 protein in OSCC tissues was 73.03%, which was higher than the 20.22% expression rate in tumor adjacent tissues, and the difference was statistically significant( χ²=49.867, P<0.001). The positive expression rate of MUC4 protein in the tissues of OSCC patients with TNM stages Ⅲ-Ⅳ, low-moderately differentiated and with lymph node metastasis were higher than those in patients with stages Ⅰ-Ⅱ, well differentiated and no lymph node metastasis, and the differences were statistically significant(P<0.01). The average survival time of patients in the MUC4 protein negative expression group was (47.00±3.35) months and the 5-year survival rate was 58.33%, which were higher than those in the positive expression group, which were (24.94±2.40) months and 20.00% 5-year survivd rate, respectively, and the log-rank test showed the difference was statistically significant( χ²=15.358, P<0.001). The TNM staging, degree of differentiation, lymph node metastasis and the expression level of MUC4 protein were independent risk factors that affected the survival time of OSCC patients(P<0.05). Conclusion: MUC4 protein was highly expressed in the tissues of OSCC patients, and was positively related to TNM stage, degree of differentiation and lymph node metastasis. It may be a potential biomarker for patient prognosis assessment.

Key words: oral squamous cell carcinoma, mucin 4, immunohistochemistry, clinical indicators, Cox proportional hazard model

中图分类号: 

• R782

• R739.8