5-羟甲基胞嘧啶表达与黑素瘤侵袭、转移、预后的相关性分析

目的 检测5-羟甲基胞嘧啶（5?hmc）在黑素瘤组织中的表达水平，分析5?hmc与黑素瘤侵袭、转移、预后的相关性。方法 采用免疫组化SP法检测5?hmc在67例黑素瘤、20例色素痣组织标本中的表达，采用Cox比例风险回归模型进行单因素和多因素回归分析5?hmc表达与黑素瘤患者预后的相关关系。结果 黑素瘤中5?hmc表达阳性率为40.30%（27/67），色素痣为75%（15/20），两组间差异有统计学意义（χ2 = 7.428，P = 0.006）。美国癌症联合会临床分期Ⅳ期黑素瘤中5?hmc表达水平明显低于Ⅱ、Ⅲ期黑素瘤（χ2 = 4.416，P = 0.036），淋巴结转移患者5?hmc表达水平明显低于无淋巴结转移患者（χ2 = 5.902，P = 0.015），且5?hmc表达水平随黑素瘤组织Clark分级升高而降低（χ2 = 4.828，P = 0.028）。5?hmc表达水平在不同年龄、性别、民族黑素瘤患者之间分布差异无统计学意义（P > 0.05）。Cox回归模型多因素分析显示，存在远处淋巴结转移（风险比：2.67，95% CI：1.22 ~ 5.84）、未手术切除（风险比：0.41，95% CI：0.18 ~ 0.95）、5?hmc低水平表达（风险比：3.54，95% CI：1.09 ~ 11.43）为预后不良的独立影响因素。结论 5?hmc可能参与黑素瘤侵袭转移，与黑素瘤预后相关。

Correlation analysis between the of 5-hydroxymethyl-cytosine and invasion,metastasis and prognosis of melanoma

Wang Ying, Kang Xiaojing, ZhaoJuan, Liang Junqin, Zhang Dezhi, Chai Li, Wang Peng, Wang WeijiaDepartment of Dermatology and Venereology, People′s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaCorresponding author: Kang Xiaojing, Email: drkangxj666@163.com【Abstract】 Objective To detect the level of 5-hydroxymethyl-cytosine（5-hmc）in melanoma tissues, and to analyze the correlation between 5-hmc and the invasion, metastasis and prognosis of melanoma. Methods A streptavidin-peroxidase immunohistochemical method was used to detect the level of 5-hmc in 67 melanoma tissues and 20 pigmented nevi tissues. Univariate and multivariate analyses were performed with the Cox′s proportional hazards regression model to analyze the correlation between the of 5-hmc and the prognosis of melanoma. Results The rate of 5-hmc was significantly lower in melanoma tissues than in pigmented nevus tissues （40.30%［27/67］ vs. 75%［15/20］, χ2 = 7.428, P = 0.006）. According to American Joint Committee on Cancer （AJCC） TNM staging system, the level of 5-hmc was significantly lower in the stage Ⅳmelanoma tissues than in the stage Ⅱ and stage Ⅲ melanoma tissues （χ2 = 4.416, P = 0.036）. Patients with lymph node metastasis showed significantly lower of 5-hmc compared with those without lymph node metastasis （χ2 = 5.902, P = 0.015）, and the level of 5-hmc significantly decreased along with the increase of Clark grade （χ2 = 4.828, P = 0.028）. There were no significant differences in the level of 5-hmc between patients of different ages, genders or nationalities （P > 0.05）. Multivariate Cox regression analysis showed that distant lymph node metastasis （HR: 2.67, 95% CI: 1.22 - 5.84）, not receiving surgical resection （HR: 0.41, 95% CI: 0.18 - 0.95）, and low of 5-hmc（HR: 3.54, 95% CI: 1.09 - 11.43）were independent risk factors for poor prognosis of melanoma. Conclusion 5-Hmc may participate in the invasion and metastasis of melanoma, and be associated with the prognosis of melanoma.