CREPT在肾癌组织中的表达及其与预后的关系

目的 探讨肾癌组织中肿瘤细胞周期相关蛋白（cell-cycle-related and expression-elevated protein in tumor，CREPT）的表达与临床病理特征和生存率的关系。方法 纳入90例于2014至2016年间在北京大学人民医院接受了根治性肾切除术并经组织学证实的肾癌患者，运用免疫组织化学方法检测这些患者的癌组织和癌旁组织中CREPT的表达，并结合临床病理资料分析CREPT表达水平与患者TNM分期和Fuhrman分级的关系。通过Kaplan-Meier生存分析及多因素COX回归分析CREPT表达与预后的关系。结果 46.7%（42/90）的患者癌组织中CREPT表达为高水平，而在癌旁组织中所有患者CREPT表达均为低水平，组间比较差异有统计学意义（P<0.05）。CREPT的表达水平与TNM分期（P=0.001）和Fuhrman分级（P<0.001）有关联，但与性别（P=0.149）、年龄（P=0.605）、肿瘤大小（P=0.673）和组织学类型（P=0.756）无关。截至2018年12月，有85例患者完成随访。Kaplan-Meier分析显示，CREPT高表达患者总生存时间和无瘤生存时间均低于CREPT低表达患者，差异有统计学意义（P<0.05）。多因素COX回归分析显示，患者总生存时间及无瘤生存时间与CREPT的表达水平有关（P<0.05）。结论 CREPT在肾癌组织中呈高表达，表达水平与临床分期、分级以及患者预后密切相关。

Relationship between CREPT expression and prognosis in renal cell carcinoma

Objective To explore the expression levels of cell-cycle-related and expression-elevated protein in tumor (CREPT) in renal cell carcinoma (RCC) and its association with cancer prognosis and patient survival. Methods A total of 90 patients who were diagnosed with RCC from 2014 to 2016 in our hospital were enrolled. Immunohistochemistry (IHC) was applied to assess CREPT expression level in RCC and adjacent normal renal tissue. The clinicopathologic features (TNM stage, Fuhrman grade) and CREPT expression level were analyzed. Furthermore, prognostic significance of CREPT was evaluated with Kaplan-Meier survival analysis. Results The expression of CREPT was high in 46.7% (42/90) of the cancer tissues, but low in all the adjacent normal tissues. The difference between groups was statistically significant (P<0.05). The degree of CREPT expression was significantly associated with TNM stage (P=0.001) and Fuhrman grade (P<0.001). However, no significant relationship between CREPT and gender (P=0.149), age (P=0.605), tumor size (P=0.673) and histological type (P=0.756) were identified. Totally 85 patients had completed follow-up until December 2018. The Kaplan-Meier analysis showed that patients with higher expression level of CREPT had significantly worse overall survival (OS) (P<0.05) and disease-free survival (DFS) (P<0.05). Conclusions CREPT was highly expressed in RCC. The expression level was positively associated with the degree of malignancy, clinical stage, and cancer prognosis.