XPO4在子宫内膜癌中的表达及与临床病理参数和预后的关系

目的:研究输出蛋白4（XPO4）在子宫内膜癌中的表达及其与临床病理参数的关系并分析其在子宫内膜癌诊断及预后评估中的意义。方法:收集本院90例子宫内膜癌患者的临床资料，采用实时荧光定量PCR（qRT-PCR）与免疫组化法检测XPO4在子宫内膜癌组织及正常组织（78例）中的表达，分析其与患者临床病理参数的关系。受试者工作特征曲线（ROC）分析XPO4表达对子宫内膜癌的临床诊断价值；Kaplan-Meier法对患者预后进行生存分析；COX比例风险模型对影响患者预后多因素进行分析。结果:与正常组相比，子宫内膜癌组XPO4 mRNA与阳性表达显著降低（P<0.05）；XPO4表达与淋巴结转移、FIGO分期、病理分级、肌层浸润深度显著相关（P<0.05）；ROC分析显示XPO4 AUC为0.843；Kaplan-Meier分析显示XPO4阳性表达组PFS、OS均显著高于阴性表达组（P<0.05）；COX多因素回归分析显示病理分级与XPO4表达水平降低均为子宫内膜癌患者预后的独立危险因素。结论:子宫内膜癌组织中XPO4表达水平显著降低并与患者临床病理参数及预后密切相关，可作为早期诊断子宫内膜癌及评估患者预后的生物学标志物。

The expression of XPO4 in endometrial carcinoma and its relationships with clinicopathological parameters and prognosis

Objective:To study the expression of exportin 4(XPO4)in endometrial carcinoma and its relationship with clinicopathological parameters，and to analyze its significance in the diagnosis and prognosis evaluation of endometrial carcinoma.Methods:The clinical data of 90 patients with endometrial carcinoma were collected.The expression of XPO4 in endometrial carcinoma tissues and normal tissues(78 cases)was detected by quantitative real-time PCR(qRT-PCR)and immunohistochemistry，and its relationships with clinicopathological parameters were analyzed.The value of XPO4 expression in the diagnosis of endometrial carcinoma was analyzed by ROC.Kaplan-Meier method was used to analyze the prognosis of patients.COX proportional hazards model was used to analyze the factors influencing the prognosis of patients.Results:Compared with the normal group，the XPO4 mRNA expression and positive expression in endometrial carcinoma group were significantly decreased(P<0.05).XPO4 expression was significantly correlated with lymph node metastasis，FIGO staging，pathological grading and depth of myometrial invasion (P<0.05).ROC analysis showed that the XPO4 AUC was 0.843.Kaplan-Meier analysis showed that PFS and OS in XPO4 positive expression group were significantly higher than those in negative expression group(P<0.05).COX multivariate regression analysis showed that pathological grading and the decrease of XPO4 expression were independent risk factors for the prognosis of endometrial cancer patients.Conclusion:The expression level of XPO4 in endometrial carcinoma tissues is decreased significantly，and is closely related to clinicopathological parameters and prognosis.It can be used as a biomarker for early diagnosis and prognosis evaluation of endometrial carcinoma.