脑胶质瘤组织中OCT4A和OCT4B水平及临床意义分析

摘要

目的 探讨脑胶质瘤组织中八聚体结合转录因子4(OCT4)剪切变体OCT4A和OCT4B水平及临床意义.方法 收集本院2011年1月至2016年12月手术切除并经病理证实的脑胶质瘤组织84例和正常脑组织36例,采用实时荧光定量PCR(QPCR)检测以上组织中的OCT4A和OCT4B mRNA水平,分析脑胶质瘤组织中OCT4A和OCT4B mRNA水平与临床病理参数(年龄、性别、病理分级、病理类型、分化程度、瘤周水肿及浸润深度)和预后的关系,采用Cox比例风险回归模型分析影响预后的因素.结果 84例脑胶质瘤组织中的OCT4A mRNA水平为2.144±1.293,高于36例正常组织的1.181±0.688(t＝4.212,P＜0.001);OCT4B mRNA水平为2.912±1.540,亦高于正常组织的1.258±0.882(t＝6.025,P＜0.001);脑胶质瘤组织中OCT4A和OCT4B mRNA水平呈正相关(r＝0.462,P＝0.012).脑胶质瘤组织中OCT4A和OCT4B水平与患者的性别、年龄和瘤周水肿均无关,而与病理类型、分化程度和病理分级有关,且在胶质母细胞瘤、低分化和病理分级Ⅲ～Ⅳ级患者中较高(P＜0.05).单因素分析发现脑胶质瘤患者的总生存期与性别、年龄、瘤周水肿和浸润深度均无关,而与病理类型、分化程度、病理分级及OCT4A和OCT4B表达水平有关(P＜0.05);Cox风险比例回归模型分析发现病理类型、分化程度、病理分级及OCT4A和OCT4B表达水平为影响预后的独立因素,其中胶质母细胞瘤、低分化程度、病理分级较晚及OCT4A、OCT4B高表达为风险因素.结论 脑胶质瘤组织中 OCT4A和 OCT4B水平升高,且与病理类型、分化程度和病理分级有关,OCT4A和OCT4B高表达者的预后较差,可能参与了该恶性肿瘤的发生发展,对脑胶质瘤的诊治及预后预测有一定意义.%Objective To investigate the levels of octamer-binding transcription factor 4 (OCT4)spliced variants OCT4A and OCT4B in glioma tissues and their clinical significances. Methods From January 2011 to December 2016,84 cases of glioma tis-sues and 36 cases of normal brain tissues were collected.The mRNA levels of OCT4A and OCT4B in the above tissues were analyzed by real-time fluorescence quantitative PCR (QPCR). The relationship between mRNA levels of OCT4A and OCT4B in glioma tissues and their clinicopathological parameters (age,sex,pathological grade,pathological type,differentiation degree,peritumoral edema and in-filtration depth)as well as prognosis was analyzed. Cox proportional hazards regression model was used to analyze prognostic factors. Results In 84 cases of glioma tissues,mRNA levels of OCT4A and OCT4B were 2.144±1.293 and 2.912±1.540,higher than 1.181 ±0.688 and 1.258±0.882 in 36 cases of normal tissues (t＝4.212 and 6.025,P＜0.001). There was a positive correlation between OCT4A and OCT4B mRNA levels in glioma tissues (r＝0.462,P＝0.012). The levels of OCT4A and OCT4B in glioma tissues were not related with sex,age and peritumoral edema,but with pathological type,differentiation degree and pathological grade. Higher levels of OCT4A and OCT4B were observed in glioblastoma,poorly differentiated and pathological grade Ⅲ-Ⅳ patients as compared with its counterparts (P＜0.05). Univariate analysis showed that the overall survival of glioma patients was not related with sex,age, peritumoral edema and depth of invasion,but with pathological type,differentiation degree,pathological grade and expression level of OCT4A and OCT4B (P＜0.05). Cox risk ratio regression model analysis revealed pathological type,differentiation degree,pathological grade and expression levels of OCT4A and OCT4B were independent prognostic factors,and glioblastoma,low differentiation,late pathological grade and high expression of OCT4A,OCT4B were risk factors. Conclusion The levels of OCT4A and OCT4B in glioma tissues are elevated,which are related with pathological type,differentiation degree and pathological grade. The prognosis of patients with high expression of OCT4A and OCT4B is poor,and may be involved in the occurrence and development of this malignant tumor. It has certain significance for the diagnosis,treatment and prognosis prediction of glioma.