【摘要】 目的 探讨胰腺癌组织低密度脂蛋白受体相关蛋白6(LRP6)、半乳糖凝集素1(LGALS1)、E盒锌指结合蛋白1(ZEB1)表达与临床病理特征及预后的关系。方法 选择2019年5月至2021年11月邯郸市第一医院收治的155例胰腺癌患者作为研究对象，免疫组化法检测胰腺癌组织及对应癌旁组织中LRP6、LGALS1、ZEB1的表达；分析胰腺癌组织LRP6、LGALS1、ZEB1表达与患者预后的关系；多因素Cox回归法分析影响胰腺癌患者预后的因素。结果 胰腺癌组织中LRP6、LGALS1、ZEB1阳性表达率显著高于癌旁组织（χ~2=100.428、88.905、83.361，均P<0.001）；肿瘤中低分化、ⅡB分期的胰腺癌患者LRP6、LGALS1、ZEB1阳性表达率显著高于高分化（χ~2=19.671、8.760、10.899,P=0.001、0.003、0.001）、Ⅰ～ⅡA分期（χ~2=5.788、4.084、6.567,P=0.016、0.043、0.010）的胰腺癌患者。随访截至2024年11月，胰腺癌组织中LRP6、LGALS1、ZEB1阳性表达的胰腺癌患者生存率均显著低于阴性表达的胰腺癌患者（Log-rank检验，χ~2=16.208、9.867、17.989，均P<0.001）。与存活的胰腺癌患者相比，死亡的胰腺癌患者中低分化、ⅡB期占比显著升高（χ~2=6.784、7.984,P=0.009、0.005）。肿瘤中低分化（HR=2.861,95%CI 1.261-6.491,P=0.012），ⅡB分期（HR=1.894,95%CI 1.122-3.196,P=0.017）,LRP6阳性（HR=2.361,95%CI 1.306-4.267,P=0.004）、LGALS1阳性（HR=2.557,95%CI 1.181-5.535,P=0.017）、ZEB1阳性（HR=1.956,95%CI1.203-3.180,P=0.007）是影响胰腺癌患者预后的独立危险因素。结论 胰腺癌组织中LRP6、LGALS1、ZEB1显著高表达，三者与肿瘤分化程度、临床分期密切相关，可能是影响胰腺癌预后的重要因素。更多还原

【Abstract】 Objective To investigate the relationship between the expression of low density lipoprotein receptor-related protein 6(LRP6), lectin galactoside-binding soluble 1(LGALS1), Zinc finger E-box-binding homeobox protein 1(ZEB1) and clinicopathological features and prognosis in pancreatic cancer. Methods A total of 155 pancreatic cancer patients, who admitted to Handan First Hospital from May 2019 to November 2021, were labeled as the study subjects. Immunohistochemistry was used to detect the expressions of LRP6, LGALS1, and ZEB1 in pancreatic cancer tissue and the corresponding paracancerous tissue. The relationship between LRP6, LGALS1, ZEB1 in pancreatic cancer tissue and the prognosis of patients was analyzed. In addition, multivariate Cox regression was used to analyze the factors affecting the prognosis of pancreatic cancer patients. Results The positive expression rates of LRP6, LGALS1, and ZEB1 in pancreatic cancer tissues were significantly higher than those in paracancerous tissue(χ~2=100.428, 88.905, 83.361; all P<0.001). The positive expression rates of LRP6, LGALS1, and ZEB1 in pancreatic cancer patients with low to moderate tumor differentiation(χ~2=19.671, 8.760, 10.899; P=0.001, 0.003, 0.001) and stage ⅡB(χ~2=5.788, 4.084, 6.567; P=0.016, 0.043, 0.010) were significantly higher than those in patients with high tumor differentiation and stage Ⅰ-ⅡA. With a follow-up till to November 2024, patients with positive expression of LRP6, LGALS1, and ZEB1 had significantly lower survival rates(Log-rank test: χ~2=16.208, 9.867, 17.989; all P<0.001). Compared with the surviving patients, the proportion of low to moderate tumor differentiation and stage IIB in dead pancreatic patients was significantly higher(χ~2=6.784, 7.984; P=0.009, 0.005). Low to moderate tumor differentiation(HR=2.861, 95%CI 1.261-6.491, P=0.012), stage IIB(HR=1.894, 95%CI 1.122-3.196, P=0.017), positive expression of LRP6(HR=2.361, 95%CI 1.306-4.267, P=0.004), LGALS1(HR=2.557, 95%CI 1.181-5.535, P=0.017), and ZEB1(HR=1.956, 95%CI 1.203-3.180, P=0.007) were independent risk factors for the prognosis of pancreatic cancer patients. Conclusion Significant positive expression of LRP6, LGALS1, and ZEB1 is found in pancreatic cancer, which is closely related to tumor differentiation and clinical stage, and may be important factors affecting the prognosis of pancreatic cancer.更多还原