摘要
目的分析受体酪氨酸激酶AXL在宫颈癌组织中的表达差异,并探讨其表达水平对患者预后的影响。方法收集癌症基因组图谱中宫颈鳞状细胞癌(CESC)数据集,使用ROC曲线分析AXL基因表达水平鉴别CESC的效能;使用Kaplan-Meier生存曲线分析不同AXL基因表达水平CESC患者生存差异。回顾性收集2021年1月至2024年1月温州医科大学附属第二医院手术切除的经病理检查确诊的79例宫颈癌组织及癌旁组织,采用免疫组织化学染色法检测不同组织中AXL表达差异,比较AXL高表达组(41例)和低表达组(38例)患者临床病理特征。使用Cox回归分析影响宫颈癌患者预后的因素。绘制Kaplan-Meier生存曲线比较两组患者无病生存率和总生存率。结果AXL基因表达水平鉴别CESC组与正常组的AUC=0.923,具有较高诊断效能;AXL基因高表达患者10年无病生存率和10年总生存率均显著低于低表达组(均P<0.05)。相比癌旁组织,宫颈癌组织中AXL蛋白阳性率显著升高(P<0.05);AXL高表达组中年龄>55岁、肿瘤-淋巴结-转移(TNM)分期Ⅲ~Ⅳ期、盆腔淋巴结转移患者比例显著升高(均P<0.05)。Cox回归分析显示,远处转移、AXL高表达、盆腔淋巴结转移是宫颈癌患者预后影响因素(均P<0.05)。Kaplan-Meier生存曲线分析显示,AXL高表达组患者3年无病生存率和总生存率均显著低于AXL低表达组(均P<0.05)。结论宫颈癌组织中AXL高表达预示着更差的预后,提示AXL可作为宫颈癌预后评估的指标,具有潜在的生物标志物的价值。
Objective To investigate the differential expression of the receptor tyrosine kinase AXL in cervical cancer tissues and to evaluate the impact of AXL expression level on patient prognosis.Methods The dataset of cervical squamous cell carcinoma(CESC)in The Cancer Genome Atlas was collected,and ROC curve was performed to analyze efficacy of AXL gene expression level in differentiating CESC.Kaplan-Meier survival curve was employed to evaluate the survival differences of CESC patients with different AXL gene expression levels.A retrospective collection of pathologically confirmed cervical cancer tissues and adjacent tissues from 79 patients admitted to the Second Affiliated Hospital of Wenzhou Medical University between January 2021 and January 2024 was performed.The expression differences of AXL protein between different tissues were detected using immunohistochemical staining and the clinicopathological characteristics between AXL high-expression group(41 cases)and low-expression group(38 cases)were compared respectively.Cox regression analysis was used to analyze the factors influencing the prognosis of patients with cervical cancer.Kaplan-Meier survival curve was plotted to compare the disease-free survival rate and overall survival rate of the two groups of patients.Results The AUC of AXL gene expression level in differentiating CESC group from normal group was 0.923,demonstrating high diagnostic efficacy.Patients with high AXL gene expression showed significantly lower 10-years'disease-free survival rate and overall survival rate compared to low-expression groups(both P<0.05).Compared to adjacent tissues,cervical cancer tissues exhibited significantly higher AXL protein positivity rates(P<0.05).In high-AXL expression groups,proportions of patients aged>55 years,with tumor-node-metastasis(TNM)stage Ⅲ-Ⅳ,or with pelvic lymph node metastasis were significantly elevated(all P<0.05).Cox regression analysis showed that distant metastasis,high expression of AXL,and pelvic lymph node metastasis were prognostic factors for patients with cervical cancer(all P<0.05).Kaplan-Meier survival curve analysis revealed that patients with high AXL expression had significantly lower 3-years'disease-free rate and overall survival rate than those with low expression(both P<0.05).Conclusion The high expression of AXL in cervical cancer tissues indicates a worse prognosis,suggesting that AXL can be used as a prognostic indicator for cervical cancer and has potential value as a biomarker.
作者
张大贵
韩玲
林小芳
张普
张曦
ZHANG Dagui;HAN Ling;LIN Xiaofang;ZHANG Pu;ZHANG Xi(Department of Pathology,Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;不详)
出处
《浙江医学》
2025年第24期2597-2603,共7页
Zhejiang Medical Journal
基金
温州市基础性科研项目(Y2023425)
浙江省抗癌协会-齐鲁肿瘤防治临床研究专项基金资助项目(zjskaxhqllckyxm202208)。
关键词
宫颈癌
受体酪氨酸激酶
AXL
生存分析
Cervical cancer
Receptor tyrosine kinase
AXL
Survival analysis
