| 马 欢,张 飞,张贤雨,等.去整合素-金属蛋白酶21在宫颈癌放化疗疗效及预后中的作用分析[J].肿瘤学杂志,2024,30(7):577-585. |
| 去整合素-金属蛋白酶21在宫颈癌放化疗疗效及预后中的作用分析 |
| Effect of ADAM21 Expression on Efficacy of Chemoradiotherapy and Prognosis in Patients with Cervical Cancer |
| 投稿时间：2024-01-27 |
| DOI：10.11735/j.issn.1671-170X.2024.07.B008 |
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| 中文关键词: 宫颈癌 生物信息学 去整合素-金属蛋白酶21 磷酸脱氢酶样2 疗效 预后 |
| 英文关键词:cervical cancer bioinformatics desintegrin metalloproteinase 21 phosducin like 2 efficacy prognosis |
| 基金项目:河北省卫健委医学科学研究项目（20190878） |
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| 摘要点击次数: 203 |
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| 中文摘要: |
| 摘 要：［目的］ 基于生物信息学分析宫颈癌放化疗患者中去整合素-金属蛋白酶21（desintegrin and metalloproteinase，ADAM21）的表达，探讨其对宫颈癌放化疗疗效及预后的影响。［方法］ 基于GEO数据库中数据集GSE56303、GSE56363宫颈癌放化疗疗效及TCGA数据库宫颈癌预后差异基因的筛选，获得差异基因ADAM21和磷酸脱氢酶样（phosducin like，PDCL）2。经GEPIA、TIMER、OncoLnc数据库验证ADAM21和PDCL2对宫颈癌预后的影响。选取2018年1月至2020年12月在河北北方学院附属第一医院放疗科住院的宫颈癌放化疗患者109例，采用免疫组化方法检测宫颈癌及正常组织中ADAM21的表达，分析其与临床病理特征、放化疗疗效及预后的影响。［结果］ 数据集GSE56303和GSE56363和TCGA数据库的共有差异基因为ADAM21和PDCL2。经GEPIA、TIMER、OncoLnc数据库验证，ADAM21高表达宫颈癌患者的生存率明显低于低表达者（P均<0.05）。ADAM21蛋白在宫颈癌组织和正常组织的阳性表达率分别为52.30%（57/109）和34.30%（34/99），差异具有统计学意义（P=0.009）。ADAM21阳性和阴性组相比，在FIGO分期、肿瘤大小、淋巴结转移方面有显著性差异（P均<0.05）。109例患者放化疗有效率为72.48%，ADAM21阳性表达者放化疗有效率显著低于阴性表达者（56.14% vs 90.38%，P<0.001）。随访截止至2023年1月31日，总生存率为65.14%，中位生存时间为33.77个月。与ADAM21阳性者相比，其阴性表达者的总生存率显著降低（57.89% vs 90.38%，P<0.001）。多因素Cox回归分析显示，ADAM21蛋白、FIGO分期、淋巴结转移和放化疗疗效均是影响宫颈癌预后的因素（P均<0.05）。［结论］ ADAM21蛋白在宫颈癌组织中表达升高，ADAM21阳性表达者放化疗疗效和总生存率显著性降低。ADAM21可能是影响放化疗疗效和预后的因素。 |
| 英文摘要: |
| Abstract：［Objective］ To analyze the effect of expression of a desintegrin and metalloproteinase 21 (ADAM21) on the efficacy of chemoradiotherapy and prognosis in patients with cervical cancer. ［Methods］ The differentially expressed genes associated with the efficacy of chemoradiotherapy and the prognosis of cervical cancer patients were screened from GSE56303 and GSE56363 in GEO database and in TCGA database， respectively， and the ADAM21 and phosducin like(PDCL) 2 genes were obtained from the screening. The effects of ADAM21 and PDCL2 on the prognosis of cervical cancer were confirmed by GEPIA， TIMER and OncoLnc databases. A total of 109 cervical cancer patients who underwent chemoradiotherapy in First Affiliated Hospital of Hebei North University from January 2018 to December 2020 were enrolled. The expression of ADAM21 protein in cervical cancer tissue and normal tissue samples were examined by immunohistochemical method. The association of ADAM21 protein expression with clinicopathological features， efficacy of chemoradiotherapy and prognosis of cervical cancer patients was analyzed. ［Results］ ADAM21 and PDCL2 genes were screened out from GSE56303 and GSE56363 datasets and TCGA database， respectively. The survival rate of patients with high-expression of ADAM21 was significantly lower than that with low-expression of ADAM21， which was confirmed by GEPIA， TIMER and OncoLnc databases (all P<0.05). The positive expression of ADAM21 protein in cervical cancer was significantly higher than that in normal cervical tissues ［52.30% (57/109) vs 34.30% (34/99)， P=0.009］. There were significant differences in FIGO stage， tumor diameter， lymph lode metastasis between patients with positive and negative expressions of ADAM21 ( all P<0.05). The efficacy rate of chemoradiotherapy in 109 cases was 72.48%. The efficacy rate in patients with positive ADAM21 expression was significantly lower than that in patients with negative expression (56.14% vs 90.38%， P<0.001). Followed-up on January 31，2023， the overall survival rate was 65.14%， the median survival time was 33.77 months. The overall survival rate in patients with positive ADAM21 was significantly lower than that with negative expression (57.89% vs 90.38%， P<0.001). C?紫x multivariate analysis showed that ADAM21 protein expression， FIGO stage， lymph lode metastasis and efficacy of chemoradiotherapy were independent influencing factors for the prognosis of cervical cancer (all P<0.05). ［Conclusion］ The expression of ADAM21 is upregulated in cervical cancer tissue， the efficacy and overall survival rate of cervical cancer patients with ADAM21 positive expression are significantly reduced. |
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