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中华消化病与影像杂志(电子版) ›› 2025, Vol. 15 ›› Issue (01) : 6 -10. doi: 10.3877/cma.j.issn.2095-2015.2025.01.002

论著

GNG4蛋白在胃肠道间质瘤中的表达及预后意义
汪玥1, 陆衡1, 曹洁1, 陆博文2,()   
  1. 1.226000 江苏省,南通市第一人民医院病理科
    2.226000 江苏省,南通市肿瘤医院内镜中心
  • 收稿日期:2024-02-29 出版日期:2025-02-01
  • 通信作者: 陆博文
  • 基金资助:
    江苏省第十五批“六大人才高峰”高层次人才选拔培养资助项目(WSW-236)南通市市级科技计划(指导性)立项项目(MSZ19196)

Expression of GNG4 protein and its prognostic significance in gastrointestinal stromal tumors

Yue Wang1, Heng Lu1, Jie Cao1, Bowen Lu2,()   

  1. 1.Department of Pathology, Nantong First People's Hospital,Nantong 226000, China
    2.Endoscopy Center, Nantong Tumor Hospital, Nantong 226000, China
  • Received:2024-02-29 Published:2025-02-01
  • Corresponding author: Bowen Lu
引用本文:

汪玥, 陆衡, 曹洁, 陆博文. GNG4蛋白在胃肠道间质瘤中的表达及预后意义[J/OL]. 中华消化病与影像杂志(电子版), 2025, 15(01): 6-10.

Yue Wang, Heng Lu, Jie Cao, Bowen Lu. Expression of GNG4 protein and its prognostic significance in gastrointestinal stromal tumors[J/OL]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(01): 6-10.

目的

探讨G蛋白γ亚基4(GNG4)在胃肠道间质瘤(GIST)中的表达及其临床病理与预后意义。

方法

收集2016年1月至2019年12月于南通市第一人民医院经手术切除的112例GIST样本,通过免疫组织化学染色检测组织中GNG4的表达。分析GNG4表达与GIST临床病理参数的关系,并通过Kaplan-Meier曲线与单、多变量Cox回归分析评估GNG4在GIST患者中的预后价值。

结果

GNG4蛋白的阳性染色主要定位于GIST细胞的胞质中,阳性表达率为59.8%(67/112)。与阴性表达者相比,GNG4阳性表达者有丝分裂指数(P=0.018)及军事病理研究所(AFIP)分层中、高危比例明显更高(P=0.022)。Kaplan-Meier生存曲线显示,GNG4阳性与阴性表达者的3年无病生存率(DFS)分别为51.8%和82.9%,差异有统计学意义(P=0.020)。亚组分析显示,GNG4阳性表达与中、高危GIST患者不良预后显著相关,3年DFS率分别为31.1%和73.8% (P=0.009)。单、多变量Cox分析显示AFIP风险分层(HR=2.177,95% CI 1.036~4.578,P=0.040)与GNG4表达(HR=2.551,95% CI 1.081~6.021,P=0.033)是GIST患者的独立预后因素。

结论

GNG4阳性表达是GIST高恶性潜能的标志,或许可作为患者预后不良的独立分子标志物,进一步识别高危人群。

Objective

To investigate the expression of guanine nucleotide-binding protein gamma 4 (GNG4) and its clinicopathological and prognostic significance in gastrointestinal stromal tumors(GIST).

Methods

A total of 112 surgically resected GIST samples in Nantong First People's Hospital from January 2016 to December 2019 were systematically collected, and the expression of GNG4 in these tissue samples were detected by immunohistochemistry. The correlations between the expression of GNG4 and clinicopathological parameters were analyzed, and the prognostic value of GNG4 for GIST patients was evaluated by Kaplan-Meier curve as well as the univariate and multivariate Cox regression analysis.

Results

The positive signals of GNG4 protein expression were mainly located in the cytoplasm of GIST cells, and the positive rate of its expression was 59.8% (67/112). Compared with the negative expression group, patients with positive expression of GNG4 had higher mitotic index (χ2=5.630, P=0.018) and the proportion of moderate and high risk group (P=0.022). Kaplan-Meier curves showed that the 3-year disease free survival (DFS) rates were 51.8% and 82.9% for patients with positive and negative expression of GNG4, respectively, with a statistically significant difference (P=0.020). Subgroup analysis revealed that the positive expression of GNG4 was significantly correlated with worse prognosis of GIST patients at moderate and high risk, and the 3-year DFS rates were 31.1% and 73.8%, respectively (P=0.009).Univariate and multivariate Cox analysis suggested that AFIP risk stratification (HR=2.177, 95% CI:1.036-4.578, P=0.040) and the expression of GNG4 (HR=2.551, 95% CI: 1.081-6.021, P=0.033) were independent prognostic factors for GIST patients.

Conclusion

The positive expression of GNG4 may reflect the malignant potential of GIST, and it can be used as an independent prognostic biomarker to further identify high-risk populations.

图1 GNG4蛋白在GIST组织中表达的免疫组化染色结果(×400) 注:1A 阳性表达;1B 阴性表达。
表1 GNG4表达与GIST临床病理特征的关系[例(%)]
图2 GNG4阳性、阴性表达患者的Kaplan-Meier生存曲线 注:2A 所有GIST患者(n=112);2B 极低、低危GIST组(n=70);2C 中、高危GIST组(n=42)。
表2 GIST患者预后因素的单变量Cox回归分析
表3 GIST患者预后因素的多变量Cox回归分析
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