【摘要】 目的 探讨CD3e分子相关蛋白(CD3EAP)基因表达水平与肺腺癌(LUAD)患者术后复发的关系及对预后的预测价值。方法 选取2022年1—12月于我院胸外科接受手术切除治疗的LUAD患者152例，收集患者临床病理资料和肿瘤组织样本。通过RNA测序技术检测患者肿瘤组织中CD3EAP的表达水平，将上述患者分为CD3EAP高表达组(76例)和CD3EAP低表达组(76例),对两组患者的临床病理特征进行分析比较。通过Kaplan-Meier生存分析曲线比较两组患者术后3年无复发生存率。通过Cox回归模型对影响LUAD患者预后的危险因素进行单因素和多因素分析。通过绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC)评估病理分期、吸烟史、CD3EAP表达水平对LUAD患者预后的预测价值。结果 临床病理特征分析结果显示，两组患者的性别和吸烟史情况比较具有显著差异(χ~2=5.630、4.738,P<0.05)。Kaplan-Meier生存分析结果显示，CD3EAP低表达组患者的术后3年无复发生存率显著高于CD3EAP高表达组(P<0.05)。Cox回归模型分析结果显示，病理分期为Ⅰb期及以上、有吸烟史、CD3EAP高表达与LUAD患者术后无复发生存期(RFS)缩短显著相关(HR=2.266～2.393,P<0.05)。ROC曲线的分析结果显示，采用CD3EAP表达水平、吸烟史和病理分期进行多指标联合预测LUAD患者术后RFS的AUC(0.773)显著高于采用CD3EAP表达水平单独预测的AUC(0.639)(Z=2.371,P<0.05)。结论 CD3EAP表达水平升高是LUAD患者术后复发的危险因素之一，而包含CD3EAP表达水平、病理分期和吸烟史在内的多指标联合对LUAD患者术后RFS有较高预测价值。更多还原

【Abstract】 Objective To investigate the association between the expression level of the CD3e molecule, epsilon associa-ted protein(CD3EAP) gene and postoperative recurrence in patients with lung adenocarcinoma(LUAD), as well as its value in predicting prognosis. Methods A total of 152 patients with LUAD who underwent surgical resection in Department of Thoracic Surgery in our hospital from January to December 2022 were enrolled, and clinical pathological data and tumor tissue samples were collected from all patients. RNA sequencing was used to measure the expression level of CD3EAP in tumor tissue, and the patients were divided into high CD3EAP expression group with 76 patients and low CD3EAP expression group with 76 patients. Clinicopa-thological features were compared between the two groups. The Kaplan-Meier survival curves were used to compare 3-year recurrence-free survival(RFS) rate between the two groups, and the Cox regression model was used to perform univariate and multivariate analyses of risk factors for the prognosis of LUAD patients. The receiver operating characteristic(ROC) curve was plotted, and the area under the ROC curve(AUC) was calculated to assess the value of pathological stage, smoking history, and the expression level of CD3EAP in predicting the prognosis of LUAD patients. Results The analysis of clinicopathological features showed that there were significant differences in sex and smoking history between the two groups(χ~2=5.630,4.738,P<0.05). The Kaplan-Meier survival analysis showed that the low CD3EAP expression group had a significantly higher 3-year RFS rate than the high CD3EAP expression group(P<0.05). The Cox regression model analysis showed that a pathological stage of Ⅰb or above, smoking history, and a high expression level of CD3EAP were significantly associated with a shorter RFS in LUAD patients(HR=2.266-2.393,P<0.05). The ROC curve analysis showed that the combination of the expression level of CD3EAP, smoking history, and pathological stage had a significantly higher AUC than the expression level of CD3EAP alone in predicting RFS of LUAD patients after surgery(0.773 vs 0.639,Z=2.371,P<0.05). Conclusion The increase in the expression level of CD3EAP is one of the risk factors for postoperative recurrence in LUAD patients, and the combination of the expression level of CD3EAP, pathological stage, and smoking history has a relatively high value in predicting postoperative RFS of LUAD patients.更多还原