FSTL1和TNF-α在糖尿病合并胃癌中的表达

阮洋 周轶冰 周东航

摘要：目的  探討FSTL1和TNF-α在糖尿病合并胃癌发生发展中的作用，以期为临床治疗该病提供新的思路和作用靶点。方法  选取2016年1月～2019年12月我院经手术治疗且资料完整的50例无糖尿病胃癌患者（单纯胃癌组）和50例糖尿病合并胃癌患者（糖尿病合并胃癌组）作为研究对象，检测两组患者癌组织中FSTL和TNF-α的表达情况，分析FSTL和TNF-α与糖尿病合并胃癌患者临床病理学特征（年龄、性别、肿瘤大小、病理分期、分化程度、淋巴结转移情况）的关系。结果  ①糖尿病合并胃癌组FSTL1表达低于单纯性胃癌组，TNF-α表达高于单纯性胃癌组，差异有统计学意义（P<0.05）;②糖尿病合并胃癌患者中，不同年龄、性别的患者FSTL1 和 TNF-α表达比较，差异无统计学意义（P>0.05）;不同肿瘤大小、病理分期、分化程度、淋巴结转移情况的患者FSTL1 和TNF-α表达比较，差异有统计学意义（P<0.05）;③糖尿病合并胃癌患者癌组织中FSTL1与TNF-α的表达呈负相关（rs=-0.4155，P<0.05）。结论  FSTL1和TNF-α与糖尿病合并胃癌患者癌组织的生长、增殖、分化和转移具有相关性，它们可能在糖尿病合并胃癌的发生发展中发挥着重要作用，且FSTL1与TNF-α的表达呈负相关。

关键词：FSTL1;TNF-α;糖尿病;胃癌

Abstract：Objective  To explore the role of FSTL1 and TNF-α in the occurrence and development of diabetes mellitus complicated with gastric cancer， in order to provide new ideas and targets for clinical treatment of the disease.Methods  From January 2016 to December 2019， 50 patients with diabetes-free gastric cancer （simple gastric cancer group） and 50 patients with diabetes mellitus and gastric cancer （diabetes mellitus combined with gastric cancer group） who had undergone surgical treatment and complete data were selected as the research objects. The expression of FSTL and TNF-α in cancer tissues of patients in the group， and the relationship between FSTL and TNF-α and clinicopathological characteristics （age， gender， tumor size， pathological stage， degree of differentiation， lymph node metastasis） in patients with diabetes mellitus and gastric cancer were analyzed. Results  ①The expression of FSTL1 in the diabetes mellitus combined with gastric cancer group was lower than that in the simple gastric cancer group， and the expression of TNF-α was higher than that in the simple gastric cancer group，the difference was statistically significant （P<0.05）;②The expressions of FSTL1 and TNF-α in patients with diabetes mellitus and gastric cancer of different ages and genders were not statistically different （P>0.05）; The expression of FSTL1 and TNF-α in patients with different tumor size， pathological stage， degree of differentiation， and lymph node metastasis were compared，the difference was statistically significant （P<0.05）; ③The expression of FSTL1 and TNF-α in cancer tissues of patients with diabetes mellitus and gastric cancer was negative correlation （rs=-0.4155，P<0.05）.Conclusion  FSTL1 and TNF-α were related to the growth， proliferation， differentiation and metastasis of cancer tissues in patients with diabetes mellitus and gastric cancer. They might play an important role in the occurrence and development of diabetes mellitus and gastric cancer， and the expression of FSTL1 and TNF-α was negative related.

[13]Zhou X，Xiao X，Huang T，et al.Epigenetic inactivation of follistatin-like 1 mediatestumorimmune evasion in nasopharyngeal carcinoma[J].Oncotarget，2016，7（13）：16433-16444.

[14]Bae K，Park KE，Han J，et al.Mitotic cell death caused by follistatin-like 1 inhibitionis associated with up-regulated Bim by inactivated Erk1/2 in human lung cancer cells[J].Oncotarget，2016，7（14）：18076-18084.

[15]Gold E，Risbridger G.Activins and activin antagonists in the prostate and prostate cancer[J].Mol Cell Endocrinol，2012，359（1-2）：107-112.

[16]Kudo-Saito C，Fuwa T，Murakami K，et al.Targeting FSTL1 prevents tumor bonemetastasis and consequent immunedysfunction[J].Cancer Res，2013，73（20）：6185-6193.

[17]Wang H，Wu S，Huang S，et al.Follistatin-like protein 1 contributes to dendritic cell and T-lymphocyte activation in nasopharyngeal carcinoma patients by altering nuclear factor κb and Jun N-terminal kinase expression[J].Cell Biochem Funct，2016，34（8）：554-562.

[18]American Diabetes Association（ADA）2015 Guidelines： Cardiovascular Disease Risk Management for Diabetes[J].Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease，2015（2）：37.

[19]梁懿璣.2型糖尿病血糖与炎症因子相关性分析[J]. 实用妇科内分泌杂志（电子版），2017，4（27）：83-86.

[20]郑山.tmTNF-α在胰岛素抵抗中的作用及其机制[D].华中科技大学，2015.

[21]刁卓，刘晓超，唐玉虎，等.RIP3及TNF-α在胃癌组织中的表达及临床意义[J].现代肿瘤医学，2017，25（14）：2283-2287.

[22]Pao W，Chmielecki J.Rational， biologically based treatment of EGFR-mutant non-small-cell lung cancer[J].Nat Rev Cancer，2010，10（11）：760-774.

收稿日期：2020-05-23;修回日期：2020-06-06

编辑/成森