研究结肠癌组织中Wnt7a蛋白表达与患者病理特征及预后的关系。

选取2016年5月至2018年5月广西科技大学第二附属医院收治的84例结肠癌患者，于术中收集患者结肠癌组织以及癌旁组织。采用免疫组织化学法检测Wnt7a蛋白表达情况，比较两种组织中表达差异。采用Cox比例风险模型多因素分析影响患者预后的危险因素，ROC曲线分析结肠癌组织Wnt7a蛋白表达水平对预后的预测价值。

结肠癌组织高表达率为61.90%（52/84），癌旁组织高表达率为14.29%（12/84），差异有统计学意义（P<0.001）。Wnt7a表达水平与肿瘤分化程度、TNM分期、淋巴结转移存在明显相关性（P<0.05），其中高表达组高分化、Ⅲ期、淋巴结转移占比高于低表达组，差异有统计学意义（P<0.05）。随访2年病死25例，其中高表达组20例，低表达组5例，高表达组死亡率明显高于低表达组（38.46% vs 15.63%，P=0.026），生存分析表明Wnt7a低表达组总生存时间长于高表达组（P=0.341）。Cox多因素回归分析显示，肿瘤TNM分期（95% CI：0.452~0.923）、淋巴结转移（95% CI：0.488~0.942）、Wnt7a（95% CI：1.135~4.063）是影响结肠癌患者生存的独立危险因素。ROC曲线分析显示，Wnt7a判断预后的AUC为0.837（95% CI：0.739~0.934），敏感度80.00%，特异度78.00%。

Wnt7a蛋白在结肠癌组织中高表达，对患者总生存期具有良好的预后评估价值。

To study the prognostic value of Wnt7a expression in colon cancer tissue and its relationship with pathological characteristics.

Colon cancer tissues and adjacent tissues were collected during the operation from 84 patients with colon cancer from May 2016 to May 2018 in the Second Affiliated Hospital of Guangxi University of Science and Technology. The expression of Wnt7a protein was detected by immunohistochemical method. The Cox proportional hazard model was used to analyze the risk factors that affect the prognosis of patients base on 2 years survival follow up. The ROC curve was used to analyze the predictive value of Wnt7a protein expression in colon cancer tissues.

Colon cancer tissue had more higher expression case of Wnt7a protein compared with adjacent tissues (61.90% vs 14.29%, P<0.001). Expression level of Wnt7a was positively correlated with tumor differentiation, TNM staging, and lymph node metastasis (P<0.05). There were 25 deaths in the 2-year follow-up, of whom 20 died in the high expression group and 5 died in the low expression group. The mortality rate of the high expression group was significantly higher than that of the low expression group (38.46% vs 15.63%, P=0.026). The overall survival time of low expression group was longer than that high expression group (P=0.341). Cox multivariate regression analysis showed that tumor TNM staging (95% CI: 0.452-0.923), lymph node metastasis (95% CI: 0.488-0.942), Wnt7a (95% CI: 1.135-4.063) were independent risk factors affecting the survival of colon cancer patients. ROC curve analysis showed that the AUC of Wnt7a predicting prognosis was 0.837 (95% CI: 0.739-0.934), with sensitivity as 80.00% and specificity as 78.00%.

Wnt7a protein is overexpressed in colon cancer tissues and has a good prognosis value for overall survival of patients.