【摘要】 目的：黏蛋白1(mucin 1,MUC1)在胰腺癌(pancreatic adenocarcinoma,PAAD)中的表达与患者预后的关联存在争议，部分研究显示其高表达与不良预后相关。叉状头转录因子P3(forkhead box protein 3,FOXP3)作为调节性T细胞(regulatory T cells,Tregs)的特异性标志物，在PAAD肿瘤细胞、肿瘤微环境(tumor microenvironment,TME)及癌旁胰腺组织中均有表达，但其与MUC1的潜在关联及对患者预后的提示作用尚不明确。本研究旨在探讨PAAD组织中MUC1和FOXP3的表达水平与临床病理特征的关系，以及其对患者生存预后的影响。方法：收集山西医科大学附属山西省人民医院2018年1月至2024年6月收治的28例PAAD患者手术切除标本的癌组织及癌旁组织，采用免疫组织化学法检测MUC1、FOXP3的表达，分析MUC1和FOXP3表达与PAAD患者临床病理特征及总生存期(overall survival,OS)的关系。结果：PAAD癌组织中MUC1阳性表达率高于癌旁组织(P<0.001)；癌组织中MUC1阳性患者术前血清总胆红素水平较阴性患者高(W=41.000,P=0.008)；癌组织中MUC1表达水平与术前血清总胆红素水平呈正相关(r=0.456,P=0.015)。癌组织中FOXP3蛋白阳性表达率低于癌旁组织(P=0.011)；癌组织中FOXP3阳性患者术前血清淋巴细胞计数低于阴性患者(W=101.000,P=0.010)，且肿瘤最大径较小(W=108.000,P=0.002)；癌组织中FOXP3表达水平与术前血清淋巴细胞计数(r=-0.443,P=0.018)、肿瘤最大径(r=-0.773,P<0.001)呈负相关。癌组织MUC1与FOXP3表达无关(r=0.025,P=0.898)。Kaplan-Meier分析表明癌组织中MUC1和FOXP3阳性表达均不提示预后不良(均P>0.05)，而癌旁组织中FOXP3阳性表达提示患者预后不良(AUC=0.641，χ~2=5.398,P=0.020)。结论：PAAD癌组织中MUC1表达与患者术前血清总胆红素水平呈正相关；癌组织中FOXP3表达与患者术前血清淋巴细胞计数、肿瘤最大径呈负相关。癌组织中MUC1和FOXP3表达无关联且均不提示预后不良，癌旁组织中FOXP3阳性表达可提示患者预后不良。更多还原

【Abstract】 Objective: The prognostic significance of mucin 1(MUC1) expression in pancreatic adenocarcinoma(PAAD) remains controversial, though some studies suggest a correlation with poor outcomes. Forkhead box protein 3(FOXP3), a specific marker of regulatory T cells(Tregs), is expressed in PAAD tumor cells, the tumor microenvironment(TME), and peritumoral pancreatic tissues, yet its potential association with MUC1 and prognostic implications are unclear. This study aims to investigate the relationship between the expression of MUC1 and FOXP3 in PAAD tissues, their clinicopathological relevance, and their impact on patient survival.Methods: Tumor and adjacent non-tumor tissues were collected from 28 patients with PAAD who underwent surgical resection at Shanxi Provincial People’s Hospital Affiliated to Shanxi Medical University between January 2018 and June 2024. Immunohistochemistry was used to detect MUC1 and FOXP3 expression. The associations with clinicopathological features and overall survival(OS) were analyzed.Results: MUC1 was significantly more frequently expressed in tumor tissues than in adjacent tissues(P<0.001). Patients with MUC1-positive tumors had higher preoperative serum total bilirubin levels compared to those with MUC1-negative tumors(W=41.000, P=0.008), and MUC1 expression was positively correlated with total bilirubin(r=0.456, P=0.015). FOXP3 expression in tumor tissues was significantly lower than in adjacent tissues(P=0.011). Patients with FOXP3-positive tumors had lower preoperative lymphocyte counts(W=101.000, P=0.010) and smaller tumor diameters(W=108.000, P=0.002) compared to those with FOXP3-negative tumors; FOXP3 expression was negatively correlated with lymphocyte count(r=-0.443, P=0.018) and tumor size(r=-0.773, P<0.001). There was no significant correlation between MUC1 and FOXP3 expression in tumor tissues(r=0.025, P=0.898). Kaplan-Meier analysis showed that MUC1 and FOXP3 expression in tumor tissues did not predict poor prognosis(P>0.05), while FOXP3 positivity in adjacent tissues was associated with poorer outcomes(AUC=0.641, χ2=5.398, P=0.020).Conclusion: In PAAD, MUC1 expression in tumor tissues is positively correlated with preoperative total bilirubin levels, while FOXP3 expression is negatively correlated with lymphocyte count and tumor size. MUC1 and FOXP3 expression in tumor tissues are not interrelated and do not indicate poor prognosis, but FOXP3 positivity in adjacent tissues may suggest unfavorable outcomes.更多还原