【摘要】 目的探讨间隙连接蛋白43(connexin 43,Cx43)的表达与黑色素瘤侵袭能力和预后转归的关联。方法筛选自2015年2月至2017年4月沧州市中心医院的70例恶性黑色素瘤患者为研究对象。通过询问以及查阅病例等方式收集患者的一般信息与临床病理信息;采用RT-PCR法测定患者癌组织、癌旁组织中Cx43 mRNA相对含量,并根据癌组织中Cx43 mRNA相对含量将患者分为两组,其中Cx43 mRNA相对含量<0.700为高表达组(n=39);≥0.700为低表达组(n=31)。比较两组患者的预后转归情况。结果黑色素瘤患者癌组织中Cx43 mRNA相对含量为0.671±0.052,明显低于癌旁组织的0.748±0.063,两种组织中Cx43 mRNA相对含量差异具有统计学意义(P<0.05)。TNM分期为Ⅰ、Ⅱ期的患者,癌组织中Cx43 mRNA相对含量明显高于Ⅲ、Ⅳ期的患者(0.749±0.031∶0.662±0.044);肿瘤直径<4 cm的患者癌组织中Cx43 mRNA相对含量明显高于肿瘤直径≥4 cm患者(0.752±0.073∶0.684±0.070);浸润深度为浅层的患者癌组织中Cx43 mRNA相对含量明显高于深层患者(0.744±0.051∶0.677±0.050);发生淋巴结转移患者的Cx43 mRNA相对含量明显低于未发生淋巴结转移的患者(0.692±0.064∶0.733±0.065);不同TNM分期、肿瘤直径、浸润深度、发生与未发生淋巴结转移患者间Cx43 mRNA相对含量存在明显差异(P<0.05)。Cx43 mRNA低表达组患者中位生存期为(25.43±5.29)个月,1年生存率为51.61%;高表达组患者中位生存期为(17.18±3.46)个月,1年生存率为23.08%;低表达组患者中位生存期以及1年生存率均显著优于高表达组(P<0.05)。结论 Cx43的表达与黑色素瘤侵袭能力以及预后相关,Cx43表达水平越低,表明患者肿瘤侵袭能力越强、病情越严重,且患者往往预后较差。更多还原

【Abstract】 Objective To explore the relationship between the expression of connexin 43(Cx43) and the invasion ability, prognosis and outcome of melanomas. Methods From February 2015 to April 2017, 70 patients in Cangzhou Central Hospital with malignant melanomas were selected as the subjects. General information and clinical pathology information of the patients was collected through inquiry and examination of cases. The relative content of Cx43 mRNA in the patients’ cancer tissues and adjacent tissues was determined by RT-PCR. According to the relative content of Cx43 mRNA in the cancer tissues, the 70 patients with melanomas were divided into two groups. Patients with a relative content of Cx43 mRNA less than 0.700 served as the low expression group(n=39), and patients with more than 0.700 was the high expression group(n=31). The prognosis and outcome of patients in both two groups were compared. Results The relative content of Cx43 mRNA in the cancer tissues of melanoma patients was 0.671±0.052, significantly lower than that in the adjacent tissues of 0.748±0.063. The difference was statistically significant(P<0.05). The Cx43 mRNA relative content of carcinoma in patients with TNM staging for Ⅰ + Ⅱ stage was significantly higher than that of patients in Ⅲ + Ⅳ stage(0.749±0.031∶0.662±0.044). When the diameter of the tumor was less than 4 cm, the Cx43 mRNA relative content was significantly higher than that in patients with tumors with a diameter of more than 4 cm(0.752 ±0.073∶0.684±0.070). In patients with a shallow layer infiltration depth, the Cx43 mRNA relative content of the carcinoma was significantly higher than that in patients with deep layer infiltration(0.744±0.051∶0.677±0.050). The Cx43 mRNA relative content in patients with lymph node metastasis was significantly lower than in patients without lymph node metastasis(0.692±0.064∶0.733±0.065). These above differences were statistically significant(P<0.05). In the Cx43 mRNA high expression group,the median survival time of patients was(25.43±5.29) months, and the one-year survival rate was 51.61%. The median survival time of patients in the low expression group was(17.18±3.46) months, and the one-year survival rate was 23.08%. Both median survival period and one-year survival rate in the low expression group were significantly better than those of patients in the high expression group(P<0.05).Conclusion The expression of Cx43 is related to the invasion ability and prognosis of melanomas. Lower Cx43 expression indicated stronger tumor invasion ability and more serious disease. These patients tended to have poor prognoses.更多还原