Expression and clinical significance of zinc finger protein 18 in pancreatic ductal adenocarcinoma / 中华胰腺病杂志

ABSTRACT

Objective:To investigate the expression of the zinc finger protein 18 (ZNF18) in the pancreatic ductal adenocarcinoma (PDAC) tissue and analyze its relationship with the clinicopathological features and prognosis.Methods:Cancer tissue specimens from 131 patients with PDAC who were surgically resected and pathologically confirmed at First Affiliated Hospital of Naval Medical University from March 2017 to December 2019 were collected. ZNF18 protein expression in cancer tissue was detected by immunohistochemical staining, and high and low ZNF18 expression groups were divided based on the expression level of ZNF18. . Kaplan-Meier method and Log-Rank test were used to analyze the relationship between ZNF18 expression level and overall survival rate of PDAC patients. Furthermore, the correlation between ZNF18 protein expression level and clinicopathological features was analyzed, and the Cox regression hazards model was applied for the univariate and multivariate analysis of the factors affecting the prognosis of PDAC patients.Results:82 of 131(62.60%) PDAC tissues had high ZNF18 expression, and 49(37.40%) PDAC tissues had low ZNF18 expression; the survival time in the high ZNF18 expression group was significantly higher than that in the low ZNF18 expression group (21.53±0.69 months vs 12.17±1.57 months), and the difference was statistically significant( P<0.001). Low ZNF18 expression in PDAC was associated with lymph node metastasis( P<0.05), but was not correlated with gender, age, tumor location, tumor volume, differentiation degree, TNM stage, nerve invasion, and vascular cancer thrombus. The results of the univariate analysis showed that tumor differentiation degree, TNM stage, lymph node metastasis, and ZNF18 expression were all associated with the prognosis of PDAC patients. The results of the multivariate analysis showed that tumor differentiation degree( HR=0.463, 95% CI 0.279-0.769, P=0.003), lymph node metastasis( HR=2.062, 95% CI 1.247-3.409, P=0.005), and ZNF18 expression( HR=0.416, 95% CI 0.255-0.676, P<0.001) were independent risk factors affecting the prognosis of patients with PDAC. Conclusions:Low ZNF18 expression in PDAC tissues was closely associated with lymph node metastasis and poor prognosis. ZNF18 can be used as an important molecular marker to evaluate the prognostic survival of PDAC patients.