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目的研究叉头框蛋白Q1(FOXQ1)在肝细胞癌(HCC)组织中的表达情况,探讨其对手术切除后行经肝动脉化疗栓塞术预后的影响,分析FOXQ1在评估肝癌疗效中的价值。方法收集2004年1月-2007年12月南通大学附属肿瘤医院收治的HCC患者120例。采用免疫组化分析FOXQ1在HCC组织中的表达情况,与患者临床特征进行比较。计数资料组间比较采用χ2检验;利用Kaplan-Meier曲线和log-rank分析患者术后的无瘤生存率(DFS);采用Cox比例风险回归模型进行单因素和多因素回归分析。结果免疫组化结果显示,FOXQ1在癌组织中呈深褐色,主要表达于肿瘤细胞质和细胞核中。单因素回归分析结果显示患者术后5年的DFS受肝脏TNM分期[风险比(HR)=0.347,95%可信区间(95%CI):0.210~0.573,P<0.001]、肝内肿瘤个数(HR=0.294,95%CI:0.176~0.490,P<0.001)、HBV感染情况(HR=0.395,95%CI:0.222~0.704,P=0.002)、AFP表达水平(HR=0.348,95%CI:0.207~0.586,P<0.001)、是否肝硬化(HR=0.414,95%CI:0.244~0.702,P=0.001)、FOXQ1高表达(HR=1.968,95%CI:1.171~3.308,P=0.011)等因素影响;多因素回归分析发现肝癌患者术后5年的DFS与TNM分期(HR=0.466,95%CI:0.248~0.874,P=0.017)、肝内肿瘤个数(HR=0.427,95%CI:0.216~0.844,P=0.014)、FOXQ1高表达(HR=2.896,95%CI:1.628~5.152,P<0.001)有关,FOXQ1高表达的患者治疗后无瘤生存时间小于FOXQ1低表达患者(18个月vs 26个月,χ2=5.006,P=0.025)。结论 FOXQ1可作为判断肝癌患者预后的生物标志物,用于评价肝癌治疗效果。
Objective To investigate the expression of FOXQ1 in hepatocellular carcinoma (HCC) and to investigate its effect on the prognosis of transcatheter arterial chemoembolization after resection. To evaluate the value of FOXQ1 in assessing the efficacy of hepatocellular carcinoma (HCC). Methods A total of 120 HCC patients who were admitted to Cancer Hospital of Nantong University from January 2004 to December 2007 were collected. The expression of FOXQ1 in HCC tissues was analyzed by immunohistochemistry and compared with the clinical features of the patients. Chi-square test was used to compare the data between two groups. Kaplan-Meier curve and log-rank were used to analyze the postoperative tumor-free survival (DFS). Univariate and multivariate regression analysis was performed using Cox proportional hazards regression model. Results Immunohistochemical results showed that FOXQ1 was dark brown in cancer tissues and mainly expressed in cytoplasm and nucleus of tumor. Univariate regression analysis showed that the 5-year postoperative DFS was associated with liver TNM staging [hazard ratio (HR) = 0.347, 95% confidence interval (95% CI: 0.210-0.573, P <0.001) (HR = 0.395, 95% CI: 0.222-0.704, P = 0.002), AFP expression level (HR = 0.348, 95% CI: 0.176-0.490, P <0.001) (HR = 0.414, 95% CI: 0.244-0.702, P = 0.001) and FOXQ1 was highly expressed (HR = 1.968, 95% CI: 1.171-3.308, P = 0.001) 0.011) .Multivariate regression analysis showed that the DFS and TNM stages (HR = 0.466, 95% CI: 0.248-0.874, P = 0.017) and the number of intrahepatic tumors (HR = 0.427, 95% CI: 0.216-0.844, P = 0.014) and FOXQ1 overexpression (HR = 2.896,95% CI: 1.628-5.152, P <0.001). The survival time of patients with FOXQ1 overexpression was lower than that of FOXQ1 Patients (18 months vs. 26 months, χ2 = 5.006, P = 0.025). Conclusion FOXQ1 can be used as a biomarker to predict the prognosis of patients with liver cancer and to evaluate the therapeutic effect of liver cancer.