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作者	单位	E-mail
崔晓海	西安交通大学第一附属医院胸外科陕西西安 710061；西安交通大学精准外科与再生医学国家地方联合工程研究中心陕西西安 710061	cuixiaohai@xjtufh.edu.cn
张佳	西安交通大学第一附属医院胸外科陕西西安 710061
张云锋	西安交通大学第一附属医院胸外科陕西西安 710061
刘大鹏	西安交通大学第一附属医院胸外科陕西西安 710061
张靖	西安交通大学第一附属医院胸外科陕西西安 710061

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中文摘要:

摘要目的：探讨胃癌组织中FOXQ1和Snail的表达及其与临床病理特征和预后的关系。方法：采用免疫组织化学方法检测178例胃癌组织中FOXQ1和Snail的表达，比较FOXQ1和Snail的表达与临床病理特征和生存期的关系。结果：在178例胃癌中，FOXQ1和Snail过表达分别为103例（57.8%）和87例（48.9%），76例（42.7%）同时表达FOXQ1和Snail。FOXQ1的表达与胃癌pTNM分期（P<0.001）、浸润深度（P<0.001）、淋巴结转移（P<0.001）、远处转移（P=0.001）、分化程度（P=0.002）和肿瘤直径（P=0.001）有关。Snail的表达与胃癌pTNM分期（P<0.001）、浸润深度（P<0.001）、淋巴结转移（P<0.001）、远处转移（P=0.001）、Borrmann分型（P=0.016）、分化程度（P=0.037）和肿瘤直径（P< 0.001）有关。结果表明，FOXQ1高表达与Snail表达呈正相关（r= 60.705，P<0.001）。Kaplan-Meier生存分析显示，FOXQ1或Snail表达与OS相关（P< 0.001）。单因素分析显示FOXQ1、Snail、pTNM分期、浸润深度、淋巴结转移、肿瘤直径分别与5年OS显著相关。多因素COX分析显示，FOXQ1（HR 2.621，95%CI 1.571-4.374，P< 0.001）、Snail（HR 2.925，95%CI 1.767-4.841，P<0.001）和淋巴结转移（HR 1.345，95%CI 1.130-1.601，P=0.001）是胃癌的独立预后因素。结论：FOXQ1与Snail的表达密切相关，FOXQ1与Snail的联合表达模式可作为胃癌患者更有效的预后指标。FOXQ1与Snail在胃癌上皮间质转化过程中的确切作用机制有待进一步研究。

英文摘要:

ABSTRACT Objective: To investigate the expression of FOXQ1 and Snail, their association with clinicopathologic features and prognosis in gastric cancer (GC) patients. Methods: Immunohistochemistry was used to determine the expressions of FOXQ1 and Snail in 178 specimens from patients with GC. The expression of FOXQ1 and Snail were compared with clinicopathologic features and survival. Descriptive statistics, Kaplan-Meyer, and Cox regression were used for statistical analyses. Results: Of the 178 cases, overexpression of FOXQ1 and Snail was noted in 103 (57.8%) and 87 (48.9%), respectively; coexpression of FOXQ1 and Snail was observed in 76 (42.7 %) of GC. The expression of FOXQ1 was associated with pTNM stage(P<0.001), depth of invasion(P<0.001), nodal involvement(P<0.001), metastasis(P=0.001), differentiation(P=0.002), and tumor diameter(P=0.001). While Snail expression was associated with pTNM stage(P<0.001), depth of invasion(P<0.001), nodal involvement(P<0.001), metastasis(P=0.001), the Borrmann types(P=0.016), differentiation(P=0.037) and tumor diameter(P<0.001). The result showed that high expression of FOXQ1 correlated with anomalous positivity of Snail expression (r=60.705, P<0.001). The Kaplan-Meier survival analysis showed that FOXQ1 or Snail expression was correlated with overall survival (OS) (P<0.001, P<0.001, respectively). Univariate analysis showed that FOXQ1, Snail, pTNM stage, depth of invasion, nodal involvement, metastasis and tumor diameter were significantly associated with 5-year OS respectively. Multivariate Cox analysis showed that FOXQ1 (HR 2.621, 95 % CI 1.571-4.374, P<0.001), Snail (HR 2.925, 95 % CI 1.767-4.841, P<0.001) and nodal involvement (HR 1.345, 95 % CI 1.130-1.601, P=0.001) were independent prognostic factor for patients with GC. Conclusion: The expression of FOXQ1 and Snail are closely correlated, and the combinational pattern of FOXQ1 and Snail can serve as a more effective prognostic index for GC patients. The exactly mechanism between FOXQ1 and Snail in the process of EMT in GC need further investigation.

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