DHX33作为可切除结肠癌患者术后辅助化疗预后标志物的临床研究-东南大学学报医学版

DHX33作为可切除结肠癌患者术后辅助化疗预后标志物的临床研究

单位：辽宁省健康产业集团阜新矿总医院消化内科, 辽宁阜新 123000

分类号：R735.3;R453

出版年·卷·期（页码）：2022·41·第五期（660-667）

摘要：

目的：分析可切除结肠癌（CC）患者肿瘤组织DEAH盒解旋酶33（DHX33）表达作为术后辅助化疗（ACT）预后标志物的临床意义。方法：选取2014年1月至2018年9月期间在我院经根治性手术切除的CC患者215例，所有患者术后接受标准方案的ACT。采用免疫组织化学法分析肿瘤组织和癌旁正常组织中DHX33蛋白表达。以无病生存时间及总生存时间作为主要观察终点。结果：与癌旁正常组织（17.67%，38/215）相比，53.95%（116/215）的肿瘤组织样本中DHX33呈高表达（χ²=61.545，P<0.001）。与DHX33低表达亚组相比，DHX33高表达亚组CC组织微卫星不稳定比例（P=0.020）、cTNM Ⅲ~ⅣA期比例（P=0.025）及癌旁正常组织DHX33蛋白高表达比例（P=0.049）更高。Kaplan-Meier分析显示，DHX33低表达者无病生存时间和总生存时间更长（χ²分别为12.566、13.986，均P<0.001）。单因素及多因素COX回归分析的结果显示，CC组织中DHX33蛋白高表达是影响手术+ACT治疗后复发（OR为2.321，95%CI 1.359~3.962，P=0.002）和远期死亡（OR为3.327，95%CI 1.635~6.769，P=0.001）的独立危险因素。结论：原发性肿瘤组织中DHX33高表达可能是CC患者根治性手术+ACT治疗后复发和死亡的有效预测因子。

Objective: To analyze the clinical value of DEAH-box helicase 33(DHX33) in the tumor tissues of patients with resectable colon cancer(CC) as a prognostic marker of postoperative adjuvant chemotherapy. Methods: A total of 215 patients with CC surgery in our hospital from January 2014 to September 2018 were selected, who were treated with postoperative adjuvant chemotherapy. The DHX33 expression was analyzed by immunohistochemistry. Disease-free survival and overall survival were the main endpoint. Results: Compared with normal adjacent tissues(17.67%, 38/215), 53.95%(116/215) samples showed high expression of DHX33 in tumor tissues(χ²=61.545, P<0.001). Compared with the DHX33 low expression subgroup, the proportion of microsatellite instability(P=0.020), the proportion of cTNM phase Ⅲ-ⅣA(P=0.025) in CC tissues and the proportion of DHX33 protein high expression in normal adjacent tissues(P=0.049) were higher in the DHX33 high expression subgroup. Kaplan-Meier analysis showed that the CC patients with lower DHX33 expression had longer disease-free survival and overall survival timesχ²=12.566, 13.986, P<0.001). Univariate and multivariate COX regression analysis showed that the high expression of DHX33 protein in CC tissue was an independent risk factor for recurrence(OR=2.321, 95%CI 1.359-3.962, P=0.002) and long-term death(OR=3.327, 95%CI 1.635-6.769, P=0.001). Conclusion: The high expression of DHX33 in primary tumor tissue may be an effective predictor of recurrence or death in CC patients after radical resection +ACT treatment.

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