摘要
目的 探究脑胶质瘤组织中通用转录因子IIE亚基β(General transcription factor IIE subunit beta, GTF2E2)表达对肿瘤术后短期预后的影响。方法 以2018年6月-2022年6月在中国人民解放军联勤保障部队第988医院神经外科和海军军医大学长征医院神经外科收治的61例脑胶质瘤患者为研究对象。收集脑胶质瘤组织标本,采用免疫组织化学法(Immunohistochemistry, IHC)检测GTF2E2在脑胶质瘤组织中表达水平。根据GTF2E2表达IHC评分将61例脑胶质瘤患者分为GTF2E2高表达组(n=13,IHC评分>6分)和GTF2E2低表达组(n=48,IHC评分≤6分),分析比较两组患者的脑胶质瘤世界卫生组织(Word health organization, WHO)分级、癫痫病史、术后复发、血管生成拟态(Vasculogenic mimicry, VM)形成、血管内皮生长因子(Vascular endothelial growth factor, VEGF)表达、微血管密度(Microvascular density, MVD)计数、异柠檬酸脱氢酶(Isocitrate dehydrogenase, IDH)基因突变状态、1p/19q共缺失状态、术后化疗情况等临床和病理特征;采用Kaplan-Meier生存曲线分析GTF2E2表达对脑胶质瘤患者术后6个月预后的影响;采用单因素和多因素Cox回归分析脑胶质瘤患者术后6个月预后不良的影响因素;采用受试者工作特征曲线(Receiver operating characteristic,ROC)分析影响因素对脑胶质瘤患者术后6个月预后不良的预测价值。结果 GTF2E2在脑胶质瘤组织中的表达显著高于正常脑组织(P<0.001);GTF2E2高表达组的脑胶质瘤WHO分级为Ⅳ级、癫痫病史、术后复发、VM和VEGF阳性占比以及MVD计数更多,而术后化疗、IDH为突变型的占比较低(P<0.05);Kaplan-Meier生存曲线分析,GTF2E2为高表达时脑胶质瘤患者术后6个月的预后不良率为92.31%(P<0.05);Cox回归分析,WHO分级(HR=1.359,95%CI:1.046~1.705)、GTF2E2表达(HR=1.414,95%CI:1.212~1.616)是脑胶质患者术后6个月内发生预后不良的危险因素,IDH为突变型(HR=0.524,95%CI:0.218~0.831)、术后化疗(HR=0.540,95%CI:0.229~0.852)为保护因素。ROC分析显示,脑胶质瘤WHO分级、GTF2E2表达、IDH为突变型、术后化疗对脑胶质瘤患者术后6个月预后不良均具有良好的预测效能,4种因素联合时预测效能最大(AUC=0.895)。结论 GTF2E2在脑胶质瘤中高表达,是影响脑胶质患者术后6个月内预后不良的危险因素,对脑胶质瘤患者术后6个月预后不良具有良好的预测效能,可作为潜在的预后标志物。
Objective To explore the influence of the expression of general transcription factor IIE subunit beta(GTF2E2)in glioma tissues on the short-term prognosis after tumor surgery.Methods A total of 61 patients with glioma who were admittedto the hospital from June 2018 to June 2022were selected as the research subjects.Glioma tissue specimens were collected and the expression level of GTF2E2 in glioma tissues was detected by immunohistochemistry(IHC).Based on the IHC score of GTF2E2 expression,61 patients with glioma were divided into the GTF2E2 high-expression group(n=13,IHC score>6 points)and the GTF2E2 low-expression group(n=48,IHC score≤6 points).The clinical and pathological characteristics of the 2 groups of thepatients,including the World Health Organization(WHO)grading of glioma,history of epilepsy,postoperative recurrence,formation of vasculogenic mimicry(VM),expression of vascular endothelial growth factor(VEGF),microvascular density(MVD)count,isocitrate dehydrogenase(IDH)gene mutation status,1p/19q co-deletion status and postoperative chemotherapy situation,were analyzed and compared.The Kaplan-Meier survival curve was used to analyze the impact of GTF2E2 expression on the prognosis of glioma patients 6 months after surgery.Univariate and Multivariate Cox regression analyses were conducted to identify the influencing factors for poor prognosis in patients with glioma 6 monthsafter surgery.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of these factors.Results The expression of GTF2E2 in glioma was significantly higher than that in normal brain tissue(P<0.001).In the group with high expression of GTF2E2,the glioma WHO grade was grade IV,the proportion of epilepsy history,postoperative recurrence,VM and VEGF positive,and MVD count were higher,while the proportions of postoperative chemotherapy,and mutant IDH were lower(P<0.05).Analysis of the KM survival curve analysis showed that when GTF2E2 was highly expressed,the rate of poor prognosis in glioma patients 6 months after surgery was 92.31%(P<0.05).Cox regression analysis revealed that WHO grade(HR=1.359,95%CI:1.046~1.705),GTF2E2 expression(HR=1.414,95%CI:1.212~1.616)were risk factors for poor prognosis in glioma patients within 6 months after surgery,while IDH being a mutant type(HR=0.524,95%CI:0.218~0.831)and postoperative chemotherapy(HR=0.540,95%CI:0.229~0.852)were protective factors.ROC analysis showed that all the influencing factors had high predictive value.When the four factors were combined,the predictive efficacy was the greatest(AUC=0.895).Conclusion GTF2E2 is highly expressed in gliomas and serves as a risk factor for poor prognosis within 6 months post-surgery in glioma patients.It demonstrates strong predictive efficacy for adverse outcomes at 6 months post-operation,making it a potential prognostic marker.
作者
柳振涛
卢成寅
胡宏康
田海港
杨红利
蒋磊
李经纶
LIU Zhentao;LU Chengyin;HU Hongkang;TIAN Haigang;YANG Hongli;JIANG Lei;LI Jinglun(Department of Neurosurgery,No.988 Hospital of Joint Logistic Support Force,Zhengzhou Henan 454000,China;Department of Neurosurgery,Changzheng Hospital,Naval Medical University,Shanghai 200003,China)
出处
《新疆医科大学学报》
2025年第12期1628-1636,共9页
Journal of Xinjiang Medical University
基金
河南省医学科技攻关项目(LHGJ20220911)
上海市卫健委临床专项青年基金(20204Y0239)。
关键词
通用转录因子IIE亚基β
脑胶质瘤
术后
短期预后
general transcription factor IIE subunit beta(GTF2E2)
brain glioma
postoperative
shortterm prognosis
