临床外科杂志 ›› 2026, Vol. 34 ›› Issue (3): 306-310.doi: 10.3969/j.issn.1005-6483.20250456

• 论著 • 上一篇    下一篇

基于基因表达及病理特征对可切除胰腺癌1年预后模型的构建

李建刚 吴士兴 徐新建 刘超   

  1. 830011 新疆乌鲁木齐,新疆医科大学第五附属医院肝胆胰外科
  • 收稿日期:2025-04-30 出版日期:2026-05-08 发布日期:2026-05-08
  • 通讯作者: 刘超,Email:120822571@qq.com

Construction of 1-year prognosis model of resectable pancreatic cancer based on gene expression and pathological features

LI Jiangang,WU Shixing,XU Xinjian,LIU Chao   

  1. Department of Hepatobiliary Pancreatic Surgery, the Fifth Affiliated Hospital of Xinjiang Medical University,Xinjiang,Urumqi 830011,China
  • Received:2025-04-30 Online:2026-03-20 Published:2026-05-08

摘要: 目的 筛选胰腺癌显著差异表达的基因,建立预测胰腺癌术后1年无病生存期(DFS)的量化模型。方法 2021年1月~2024年1月于我院确诊并行肿瘤根治性切除术胰腺癌病人124例,随访6~12个月,根据随访结果将其分为1年无病生存组(DFS组,75例)和复发组(49例)。应用生物信息学分析筛选差异表达基因,实时荧光定量PCR检测肿瘤组织KRAS、TP53、CDKN2A、SMAD4、FKBP1A、PLD1、PSMA4、PES1、微小RNA(miR)-320b和长链非编码RNA(LncRNA) MIR210HG基因表达量。比较两组一般资料、血生化指标和肿瘤病理特征。采用多因素Cox回归分析DFS的预测因素,R软件建立列线图,受试者工作特征(ROC)曲线评估列线图预测DFS的效能。结果 与DFS组比较,复发组白蛋白降低、最大直径≥4cm、组织学分级3级、TNM分期Ⅱb~Ⅲa期和淋巴结转移增多,TP53、PES1和LncRNA MIR210HG表达量升高,SMAD4和miR-320b表达量下降,差异有统计学意义(P<0.05)。多因素Cox回归显示,Ⅱb~Ⅲa期(HR=2.659)、淋巴结转移(HR=2.012)、PES1(HR=1.429)、LncRNA MIR210HG(HR=1.758)和miR-320b(HR=1.659)是DFS的预测因素。R软件建立列线图,ROC曲线分析显示,列线图预测DFS的ROC曲线下面积(AUC)为0.876(95%CI 0.823~0.936,P<0.001)。校准曲线拟合良好。结论 联合肿瘤病理特征和差异基因表达建立量化模型对预测胰腺癌切除术后1年DFS有较好的应用价值。

关键词: 胰腺癌; 无病生存期; 列线图; PES1; 长链非编码RNA MIR210HG; 微小RNA-320b

Abstract: Objective To screen significantly differentially expressed genes in pancreatic cancer and establish a quantitative model to predict 1-year disease-free survival (DFS) of pancreatic cancer patients.Methods From January 2021 to January 2024,124 patients with pancreatic cancer pathologically confirmed and underwent radical resection into department of hepatobiliary and pancreatic surgery of the fifth affiliated hospital of Xinjiang medical university .They were followed up for 6~12 months and divided into DFS group (n=75) and recurrence group (n=49).Bioinformatics analysis was applied to screen differentially expressed genes.KRAS,TP53,CDKN2A,SMAD4,FKBP1A,PLD1,PSMA4,PES1,miR-320b and LncRNA MIR210HG in tumor tissues were detected by real-time PCR.The general datas,blood biochemistry,tumor pathological characteristics were compared between the two groups.Multivariate Cox regression analysis was used to identify predictors of DFS. A Nomogram was established using R software, and the receiver operating characteristic (ROC) curve was employed to evaluate the predictive performance of the Nomogram for DFS.Results Compared with DFS group,albumin decreased,maximum diameter≥4 cm,histological grade 3,TNM stage Ⅱb~Ⅲa and lymph node metastasis increased,the expressions of TP53,PES1 and LncRNA MIR210HG increased,and expressions of SMAD4 and miR-320b decreased in recurrence group (P<0.05).Multivariate Cox regression showed that Ⅱb~Ⅲa (HR=2.659),lymph node metastasis (HR=2.012),PES1 (HR=1.429),LncRNA MIR210HG (HR=1.758) and miR-320b (HR=1 659) were predictive factors to DFS.The nomogram was established by R software.ROC showed that AUC of nomogram for predicting DFS was 0.876 (95%CI=0.823~0.936,P<0.001).Conclusion The quantitative model established by combining tumor pathology and differential gene expressions has good application potential for predicting 1-year DFS after pancreatic cancer resection.

Key words: pancreatic cancer; disease free survival; nomogram;PES1; LncRNA MIR210HG; microRNA-320b

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