LAT1表达水平与非肌层浸润性膀胱癌患者术后复发风险的相关性研究

Correlation between LAT1 expression level and risk of postoperative relapse in patients with non-muscle invasive bladder cancer

摘要:

目的 探讨L型氨基酸转运蛋白1（L-type amino acid transporter 1，LAT）表达水平与非肌层浸润性膀胱癌患者术后复发风险的相关性。方法 选取2021年2月至2022年2月于重庆医科大学附属永川医院接受手术治疗的非肌层浸润性膀胱癌患者108例作为研究对象，采用反转录酶聚合酶链反应测定膀胱癌组织（取自肿瘤所在部位区域）和癌旁组织（取自邻近正常区域组织）LAT1表达含量，对比膀胱癌组织和癌旁组织LAT1表达水平。同时根据膀胱癌组织LAT1表达含量的二分位数将所有患者分为高表达组和低表达组，对比2组临床病理参数。随访观察12个月观察2组术后复发情况，采用Kaplan-Meier曲线分析对比2组术后复发风险，使用多变量Cox比例风险回归模型确定术后复发的影响因素。结果 膀胱癌组织LAT1表达水平（1.80±0.35）较配对的癌旁组织LAT1表达水平（1.05±0.17）高（P<0.05）；LAT1高表达组吸烟史、临床分期T₁占比较LAT1低表达组高（P<0.05）；108例膀胱肿瘤患者术后的平均随访时间为（10.84±1.94）个月，其中33例复发，复发率为30.56%。Kaplan-Meier曲线显示，LAT1高表达组患者总体复发率较LAT1低表达组高（log-rank χ2=4.382，P=0.036）；多因素Cox回归分析显示，吸烟史（HR=6.539，95%CI=2.439~17.531）、临床分期为T₁期（HR=3.658，95%CI=1.808~7.398）、LAT1高表达（HR=3.425，95%CI=1.631~7.191）为非肌层浸润性膀胱癌患者术后复发的危险因素（P<0.05）。结论 LAT1在膀胱癌组织中表达水平高，高LAT1表达水平可能与膀胱癌患者术后复发风险增加有关。

Abstract:

Objective To explore the correlation between the expression level of L-type amino acid transporter 1（LAT1） and the risk of postoperative relapse in patients with non-muscle-invasive bladder cancer（NMIBC）.Methods A total of 108 patients with NMIBC who received surgical treatment in Yongchuan Hospital Affiliated to Chongqing Medical University from February 2021 to February 2022 were selected as subjects. LAT1 expression levels in the bladder cancer tissue （from the sites where tumor was identified） and paracancerous tissue（from adjacent normal areas） were measured by reverse transcriptase polymerase chain reaction，and the expression levels of LAT1 in the two types of tissue were compared. Meanwhile，all patients were divided into high expression group and low expression group according to the second quantile of LAT1 expression in the bladder cancer tissue，and the clinicopathological parameters of the two groups were compared. The two groups were observed and followed up for 12 months for postoperative relapse. The Kaplan-Meier curve was used to analyze and compare the risk of postoperative relapse between the two groups. The multivariate Cox proportional hazards regression model was used to determine the influencing factors for postoperative relapse.Results The LAT1 expression level in the bladder cancer tissue（1.80±0.35） was significantly higher than that in the paired paracancerous tissue（1.05±0.17）（P<0.05）. The proportion of patients with a smoking history and clinical stage T₁ was significantly higher in the high LAT1 expression group than in the low LAT1 expression group（P<0.05）. The mean follow-up time of 108 patients with bladder tumor was （10.84±1.94） months. Among these patients，33 had a relapse，with a relapse rate of 30.56%. The Kaplan-Meier curve showed that the overall relapse rate was significantly higher in patients with high LAT1 expression than in those with low LAT1 expression（log rank χ2=4.382，P=0.036）；the multivariate Cox regression analysis showed that smoking history [hazard ratio（HR）=6.539，95%CI=2.439-17.531]，clinical stage T₁（HR=3.658，95%CI=1.808-7.398），and high LAT1 expression（HR=3.425，95%CI=1.631-7.191） were risk factors for postoperative relapse of patients with NMIBC P<0.05）.Conclusion The LAT1 expression level is high in the bladder cancer tissue，and high LAT1 expression levels may be correlated with an increased risk of postoperative relapse in patients with bladder cancer.