MUC5B、MMP-9在胆管癌中的表达及临床价值分析OA

Objective To investigate the expression levels of mucin 5B(MUC5B)and matrix metalloproteinase-9(MMP-9)in patients with cholangiocarcinoma,analyze their relationship with the clinical characteristics and prognosis of the patients,and explore their clinical application value.Methods The clinical data of 160 patients with cholangiocarcinoma who were diagnosed and treated in our hospital and completed follow-up from March 2022 to October 2023 were retrospectively collected.The expression levels of MUC5B and MMP-9 were compared between cancer tissues and adjacent tissues,and were also compared among patients with different clinical characteristics.The COX regression model was used to analyze the factors influencing the prognosis of cholangiocarcinoma patients.The ROC curve was established to analyze the predictive va-lue of MUC5B and MMP-9 expression for the prognosis of cholangiocarcinoma patients.Results The expression levels of MUC5B and MMP-9 in cancer tissues were significantly higher than those in adjacent tissues(t/P=26.193/<0.001,24.772/<0.001).The expression levels of MUC5B and MMP-9 in cancer tissues were significantly higher in patients with a family his-tory,low differentiation,submucosal infiltration,tumor diameter>3 cm,pathological stage Ⅲ-Ⅳ,and lymph node metastasis than in those without a family history,with moderate to high differentiation,mucosal infiltration,tumor diameter≤3 cm,path-ological stage Ⅰ-Ⅱ,and without lymph node metastasis(MUC5B:t/P=3.946/<0.001,2.924/0.004,3.203/0.002,5.155/<0.001,2.816/0.005,4.576/<0.001;MMP-9:t/P=3.348/<0.001,2.865/<0.001,4.642/<0.001,6.069/<0.001,3.062/0.003,4.365/<0.001).Spearman correlation analysis showed that MUC5B and MMP-9 were significantly positively correlated with family history,infiltration depth,tumor diameter,pathological stage,and lymph node metastasis(MUC5B:rs/P=0.282/<0.001,0.241/0.002,0.374/<0.001,0.216/0.006,0.340/<0.001;MMP-9:rs/P=0.241/0.002,0.329/<0.001,0.434/<0.001,0.218/0.006,0.324/<0.001),and significantly negatively correlated with differentiation degree(P<0.01).Follow-up results showed that 101 out of 160 cholangiocarcinoma patients had endpoint events,with an incidence rate of 63.13%.Based on the occurrence of endpoint events,patients were divided into a favorable prognosis group(n=59)and an unfavorable prognosis group(n=101).Multiva-riate COX regression analysis showed that tumor diameter>3 cm,pathological stage Ⅲ-Ⅳ,elevated MUC5B,and elevated MMP-9 were independent risk factors for poor prognosis in cholangiocarcinoma patients(all P<0.05).Using the Cut-off value as the standard,the AUCs of MUC5B,MMP-9,and their combination were 0.879,0.886,and 0.922,respectively.At the Cut-off value,the sensitivities of MUC5B,MMP-9,and their combination were 0.772,0.752,and 0.881,respectively;the specificities were 0.831,0.898,and 0.797,respectively.Conclusion Both MUC5B and MMP-9 are highly expressed in patients with cholangiocarcinoma,and are associated with family history,differentiation degree,infiltration depth,tumor diameter,pathological stage,and lymph node metastasis.Tumor diameter>3 cm,pathological stage Ⅲ-Ⅳ,elevated MUC5B,and elevated MMP-9 are independent risk factors for poor prognosis.MUC5B and MMP-9 demonstrate good pre-dictive value for the prognosis of cholangiocarcinoma patients,and their combined use can improve the sensitivity of auxilia-ry diagnosis.