Predictive value of serum APOC1 and Klotho expression for prognosis in patients undergoing laparoscopic partial nephrectomy for renal cancer

doi:10.11958/20240969

Abstract

Abstract:

Objective To explore the clinical value of apolipoprotein C1 (APOC1) and Klotho expression levels in predicting the prognosis of patients with renal cancer after laparoscopic partial nephrectomy.Methods Eighty patients diagnosed as renal cell carcinoma and underwent laparoscopic partial nephrectomy were collected as the study subjects. According to the prognosis, patients were separated into the good prognosis group (61 cases) and the poor prognosis group (19 cases). Seventy-eight healthy individuals underwent physical examination were collected as the control group. The general clinical data of the subjects were collected, and serum levels of APOC1 and Klotho were tested and analyzed in three groups. Pearson method was applied to analyze the correlation between serum APOC1 and Klotho levels in patients. Cox regression was applied to analyze factors affecting the prognosis of patients. Receiver operating characteristic (ROC) curve was applied to analyze the predictive efficacy of APOC1 and Klotho levels on the prognosis of patients.Results There were significant differences in clinical stage and pathological grade between the poor prognosis group and the good prognosis group (P<0.05). Compared with the control group, the serum APOC1 levels were significantly increased in the good prognosis group and the poor prognosis group (P<0.05), while the Klotho expression levels were obviously reduced (P<0.05). And the serum APOC1 level in the control group, the poor prognosis group and the good prognosis group was increased successively (P<0.05), while the serum Klotho level was obviously decreased successively (P<0.05). The serum APOC1 expression level of patients was negatively correlated with Klotho level (r=-0.577, P<0.001). The Cox regression results showed that decreased expression level of Klotho and elevated expression level of APOC1, pathologic grading 2 and clinical staging stage Ⅱ were all independent risk factors for poor prognosis (P<0.05). The area under the curve (AUC) of serum APOC1 and Klotho levels, and their combined application in predicting poor postoperative prognosis in renal cancer patients was 0.863, 0.850 and 0.953, respectively, and the clinical value of combination of the two in predicting the prognosis of patients was superior to that of APOC1 and Klotho alone.Conclusion Patients with poor prognosis after retroperitoneal laparoscopic partial nephrectomy have a obvious increase in serum levels of APOC1 and a obvious decrease in serum level of Klotho. The combination of the two has high clinical significance in predicting the prognosis of patients with retroperitoneal laparoscopic partial nephrectomy.

Key words: kidney neoplasms, apolipoprotein C1, Klotho, retroperitoneal laparoscopic partial nephrectomy for renal cancer, prognosis

CLC Number:

R737.11

Figures/Tables 6

References 19

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基因	引物序列（5′→3′）	产物大小/bp
APOC1	上游：AGGACAAGGCTCGGGAACTCAT	227
	下游：GATGTCACCCTTCACTCCTCA	227
Klotho	上游：ACCTGGTGGCGCACAC	168
	下游：TTGGCAAACCAACCTAGTACA	168
GAPDH	上游：GACCTGGTGGCGCACAC	202
	下游：GAAGATGGTGATGGGATTTC	202

基因	引物序列（5′→3′）	产物大小/bp
APOC1	上游：AGGACAAGGCTCGGGAACTCAT	227
	下游：GATGTCACCCTTCACTCCTCA	227
Klotho	上游：ACCTGGTGGCGCACAC	168
	下游：TTGGCAAACCAACCTAGTACA	168
GAPDH	上游：GACCTGGTGGCGCACAC	202
	下游：GAAGATGGTGATGGGATTTC	202

组别		n	性别				年龄/岁		病程/年		病理分级
组别		n	男		女		年龄/岁		病程/年		1级		2级
对照组		78	45（57.69）		33（42.31）		61.53±10.95		-		-		-
预后良好组		61	40（65.57）		21（34.43）		61.38±11.26		1.69±0.38		42（68.85）		19（31.15）
预后不良组		19	13（68.42）		6（57.69）		61.95±12.03		1.74±0.40		6（31.58）		13（68.42）
χ²、F或t			1.278				0.019		0.495		8.387^＊
组别	肿瘤类型					TNM分期				Scr/（μmol/L）		BUN/（mmol/L）
组别	透明细胞癌			乳头状肾细胞癌		Ⅰ期		Ⅱ期		Scr/（μmol/L）		BUN/（mmol/L）
对照组	-			-		-		-		73.19±10.86		6.96±0.98
预后良好组	52（85.25）			9（14.75）		39（63.93）		22（36.07）		106.85±13.37^a		9.83±1.35^a
预后不良组	15（78.95）			4（21.05）		7（36.84）		12（63.16）		121.43±15.29^ab		12.01±1.97^ab
χ²或F	0.086					4.351^＊				185.581^＊		159.837^＊

组别		n	性别				年龄/岁		病程/年		病理分级
组别		n	男		女		年龄/岁		病程/年		1级		2级
对照组		78	45（57.69）		33（42.31）		61.53±10.95		-		-		-
预后良好组		61	40（65.57）		21（34.43）		61.38±11.26		1.69±0.38		42（68.85）		19（31.15）
预后不良组		19	13（68.42）		6（57.69）		61.95±12.03		1.74±0.40		6（31.58）		13（68.42）
χ²、F或t			1.278				0.019		0.495		8.387^＊
组别	肿瘤类型					TNM分期				Scr/（μmol/L）		BUN/（mmol/L）
组别	透明细胞癌			乳头状肾细胞癌		Ⅰ期		Ⅱ期		Scr/（μmol/L）		BUN/（mmol/L）
对照组	-			-		-		-		73.19±10.86		6.96±0.98
预后良好组	52（85.25）			9（14.75）		39（63.93）		22（36.07）		106.85±13.37^a		9.83±1.35^a
预后不良组	15（78.95）			4（21.05）		7（36.84）		12（63.16）		121.43±15.29^ab		12.01±1.97^ab
χ²或F	0.086					4.351^＊				185.581^＊		159.837^＊

组别	n	APOC1	Klotho
对照组	78	1.04±0.08	1.02±0.09
预后良好组	61	1.18±0.17^a	0.83±0.15^a
预后不良组	19	1.53±0.23^ab	0.61±0.12^ab
F		91.198^＊	104.780^＊