摘要
目的探讨非小细胞肺癌(NSCLC)患者三结构域蛋白41(TRIM41)的表达及临床意义。方法本研究为队列研究。采用便利抽样法,选取2021年7月至2023年3月山东第一医科大学第二附属医院收治的106例NSCLC患者。所有患者均行肺癌根治术获得病理标本,比较癌组织及癌旁组织TRIM41阳性率。根据NSCLC患者癌组织TRIM41表达情况分为TRIM41阳性组(41例)和TRIM41阴性组(65例),比较TRIM41阳性组与TRIM41阴性组NSCLC患者的临床特征。采用Kaplan-Meier法绘制生存曲线,log-rank检验比较不同特征NSCLC患者的生存曲线,采用多因素Cox回归分析NSCLC患者预后影响因素。结果NSCLC患者癌组织TRIM41阳性率高于癌旁组织[38.68%(41/106)比8.49%(9/106),χ^(2)=26.80,P<0.001]。TRIM41阳性组男22例,女19例,年龄(66.12±5.24)岁;TRIM41阴性组男40例,女25例,年龄(68.42±5.49)岁。2组患者性别、年龄比较差异均无统计学意义(均P>0.05)。TRIM41阳性组TNM分期高于TRIM41阴性组(Z=8.17,P=0.004)。随访时间为27.1(6.3~42.0)个月,生存分析显示,TNM分期为Ⅲ期患者的累积无病生存率低于Ⅰ期患者和Ⅱ期患者(25.78%比84.85%比65.70%,整体χ^(2)=17.36,P<0.001;Ⅲ期比Ⅱ期χ^(2)=15.72,P<0.001;Ⅲ期比Ⅰ期χ^(2)=7.47,P=0.006;Ⅱ期比Ⅰ期χ^(2)=6.21,P=0.013)。癌组织TRIM41阳性患者的累积无病生存率低于癌组织TRIM41阴性患者(40.40%比68.63%,χ^(2)=8.32,P=0.004)。多因素Cox回归分析显示,TNM分期升高(HR=2.812,95%CI:1.292~6.123)、有区域淋巴结转移(HR=2.282,95%CI:1.365~3.813)、肿瘤最大长径≥5 cm(HR=1.517,95%CI:1.039~2.215)、癌组织TRIM41表达阳性(HR=2.195,95%CI:1.177~4.093)是NSCLC患者肿瘤复发的独立危险因素(均P<0.05)。结论NSCLC患者癌组织中TRIM41阳性表达率较高,TRIM41阳性表达更常见于TNM分期高的患者,这预示着该群体具有更高的肿瘤复发风险。
Objective To evaluate the expression of tripartite motif protein 41(TRIM41)in non-small cell lung cancer(NSCLC)and its association with clinicopathological features and prognosis.Methods This cohort study employed convenience sampling to enroll 106 patients with NSCLC who underwent radical resection at the Second Affiliated Hospital of Shandong First Medical University from July 2021 to March 2023.TRIM41 expression in tumor and adjacent normal tissues was assessed,and patients were classified as TRIM41-positive(n=41)or TRIM41-negative(n=65)based on tumor tissue staining.Clinicopathological variables were compared between groups.Survival curves were plotted using the Kaplan-Meier method and compared using the log-rank test.Multivariate Cox regression analysis was used to analyze factors influencing prognosis in NSCLC patients.Results The TRIM41 positivity rate was significantly higher in tumor tissues than in adjacent tissues(38.68%[41/106]vs 8.49%[9/106];χ^(2)=26.80,P<0.001).Demographic characteristics were similar between TRIM41-positive and-negative groups(TRIM41-positive:22 males and 19 females;mean age 66.12±5.24 years;TRIM41-negative:40 males and 25 females;mean age 68.42±5.49 years).There were no statistically significant differences in gender and age between the two groups(all P>0.05).TRIM41-positive tumors were associated with more advanced TNM stage(Z=8.17,P=0.004).Median follow up was 27.1 months(range 6.3-42.0).Survival analysis showed that the cumulative disease-free survival(DFS)of patients with TMN stageⅢwas significantly lower than that of patients with stageⅠandⅡ(25.78%vs 84.85%vs 65.70%,overall:χ^(2)=17.36,P<0.001;stageⅢvs stageⅡ:χ^(2)=15.72,P<0.001;stageⅢvs stageⅠ:χ^(2)=7.47,P=0.006;stageⅡvs stageⅠ:χ^(2)=6.21,P=0.013).Patients with TRIM41-positive tumors had significantly lower cumulative DFS than those with TRIM41-negative tumors(40.40%vs 68.63%;log-rankχ^(2)=8.32,P=0.004).Multivariate Cox regression analysis identified higher TNM stage(HR=2.812;95%CI:1.292-6.123),regional lymph node metastasis(HR=2.282;95%CI:1.365-3.813),maximum tumor diameter≥5 cm(HR=1.517;95%CI:1.039-2.215),and positive TRIM41 expression in tumor tissue(HR=2.195;95%CI:1.177-4.093)as independent predictors of tumor recurrence in NSCLC patients(all P<0.05).Conclusion TRIM41 is frequently expressed in tumor tissues of NSCLC patients,and positive TRIM41 expression is more common in patients with advanced TNM stage,indicating that this subgroup carries a higher risk of tumor recurrence.
作者
刘美君
邵玲玲
陈冉
阴其玲
刘圆圆
Liu Meijun;Shao Lingling;Chen Ran;Yin Qiling;Liu Yuanyuan(Shandong First Medical University,Jinan 250000,China;Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Shandong First Medical University,Tai'an 271000,China)
出处
《国际呼吸杂志》
2025年第11期951-957,共7页
International Journal of Respiration
关键词
癌
非小细胞肺
三结构域蛋白41
生存分析
Carcinoma,non-small-cell lung
Tripartite motif containing protein 41
Survival analysis
