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目的:探讨乙酰肝素酶(HPA)在人喉鳞状细胞癌组织中的表达水平与临床分期、T分级、淋巴结转移、病理分化程度等临床病理参数的关系,并分析HPA表达和细胞定位与预后的关系。方法:采用免疫组织化学法检测HPA蛋白在73例喉鳞状细胞癌组织中的表达,分析其与病理特征的关系。Fisher精确检验和卡方检验比较计数资料,Kaplan-Meier生存曲线与Log-rank检验分析生存情况,单因素及多因素COX比例风险回归分析独立预后因子。结果:HPA蛋白在喉鳞状细胞癌组织和对照组息肉组织中的阳性表达率分别为76.71%(56/73)和21.05%(8/38),差异有统计学意义(P<0.05)。HPA的表达水平在不同的临床分期、病理分化、T分级及淋巴结转移之间差异均有统计学意义(均P<0.05),而在性别、年龄、临床分型之间的差异无统计学意义(均P>0.05);单因素分析结果显示喉癌患者HPA蛋白高表达组比HPA低表达组的生存时间更短,HPA高表达组的中位生存时间和5年生存率分别为24个月、43.33%,低表达组分别为56个月、61.54%,未表达组分别为65个月、70.59%。临床分期、T分级、淋巴结是否转移、分化程度与生存时间差异有统计学意义(均P<0.05),而年龄、性别、临床分型与患者的预后差异均无统计学意义(均P>0.05)。多因素COX比例风险回归分析结果提示,淋巴结转移、HPA表达水平和HPA定位是3个独立的喉癌预后因子。此外,HPA表达的细胞定位与喉癌患者的预后密切相关,喉癌组织细胞核HPA染色阳性患者与细胞质HPA染色阳性患者的生存率差异有统计学意义(P<0.05)。结论:HPA阳性表达与较差的生存相关,可以考虑作为一个潜在的预后不良的标志物,HPA在细胞质的定位表达为预后较差的标志,而HPA在细胞核的定位表达则为较好的预后标志。
Objective: To investigate the relationship between the expression of heparanase (HPA) in human laryngeal squamous cell carcinoma and clinicopathologic parameters such as clinical stage, T grade, lymph node metastasis and pathological differentiation, and to analyze the relationship between HPA expression and cell location and Prognosis of the relationship. Methods: The expression of HPA protein in 73 cases of laryngeal squamous cell carcinoma was detected by immunohistochemistry, and its relationship with pathological features was analyzed. Fisher exact test and chi-square test were used to compare the count data, Kaplan-Meier survival curve and Log-rank test to analyze the survival status, single factor and multivariate COX proportional hazard regression analysis of independent prognostic factors. Results: The positive expression rates of HPA protein in polyp tissues of laryngeal squamous cell carcinoma and control group were 76.71% (56/73) and 21.05% (8/38), respectively. The difference was statistically significant (P <0.05). The expression of HPA in different clinical stages, pathological differentiation, T grade and lymph node metastasis were significantly different (all P <0.05), but no significant difference in gender, age, clinical classification (All P> 0.05). The results of univariate analysis showed that the survival time of patients with high expression of HPA protein in laryngeal cancer group was shorter than that of HPA low expression group, and the median survival time and 5-year survival rate of HPA high expression group were 24 months , 43.33% in the low expression group, 56.56% in the low expression group and 61.54% in the non-expression group, respectively, 65.5 months and 70.59% respectively. There were significant differences in clinical stage, T grade, lymph node metastasis, differentiation degree and survival time (all P <0.05), but there were no significant differences in age, gender, clinical classification and prognosis ). Multivariate COX proportional hazards regression analysis suggested that lymph node metastasis, HPA expression and HPA localization were three independent predictors of laryngeal cancer. In addition, the cell location of HPA expression was closely related to the prognosis of patients with laryngeal carcinoma. There was significant difference in the survival rate between HPA-positive patients with cytoplasmic HPA staining and laryngeal carcinoma (P <0.05). CONCLUSIONS: The positive expression of HPA correlates with poor survival and may be considered as a potential marker of poor prognosis. HPA expression in cytoplasm may be a marker of poor prognosis, whereas HPA expression in the nucleus may be a better prognosis Sign.