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目的 ：探讨丝氨酸棕榈酰转移酶小亚基A(serine palmitoyltransferase small subunit A,SPTSSA)在乳腺癌中的表达及其预后意义。方法：通过癌症基因组图谱数据库获取数据，采用生物信息学和多重免疫组化技术，结合Cox回归模型分析SPTSSA在乳腺癌中的表达情况及其预后意义。结果：生物信息学分析发现SPTSSA mRNA在乳腺癌组织中的表达高于癌旁正常组织(P<0.001),Kaplan-Meier生存分析显示，SPTSSA表达水平较高患者总生存期低于表达水平较低患者(P<0.001)。多重免疫组化技术显示，相较于癌旁正常组织，乳腺癌组织中SPTSSA蛋白表达明显增高(P=0.001),Kaplan-Meier生存曲线显示，SPTSSA蛋白高表达患者OS较短(P<0.0001)。在乳腺癌肿瘤区域中SPTSSA蛋白高表达与TNM分期(P=0.007)、淋巴结转移(P=0.005)有关，在间质区域中SPTSSA蛋白高表达与TNM分期(P=0.024)有关。单因素Cox回归分析显示，SPTSSA在肿瘤细胞中表达与间质细胞中表达的差异有统计学意义(P<0.01)。肿瘤大小(P=0.023)、淋巴结转移(P=0.002)、远处转移(P=0.012)、TNM分期(P=0.001)均与患者生存率有关。多因素Cox回归分析显示，SPTSSA在肿瘤细胞及间质细胞中的表达(P<0.001)、TNM分期(P<0.001)与患者生存率有关。多重免疫组化实验发现，SPTSSA蛋白表达与肿瘤区域CD68~+CD163+巨噬细胞(r=0.234,P=0.01)及基质区域CD3~+CD4~+T细胞(r=0.200,P=0.018)存在显著相关；程序性死亡受体-1(programmed death 1,PD1)(r=0.220,P=0.008)及细胞毒性T淋巴细胞相关抗原4(cytotoxic T lymphocyte-associated antigen 4,CTLA-4)(r=0.225,P=0.007)的表达与乳腺癌肿瘤区SPTSSA水平呈正相关，而与间质区SPTSSA水平无关。结论：SPTSSA在乳腺癌组织中的表达显著升高，影响肿瘤微环境，与患者预后密切相关。
Abstract：Objective: To explore the expression of serine palmitoyltransferase small subunit A(SPTSSA) in breast cancer and its prognostic significance. Methods: Data were obtained from the Cancer Genome Atlas database. Using bioinformatics and multiple immunohistochemical techniques, combined with the Cox regression model, the expression of SPTSSA in breast cancer and its prognostic significance were analyzed. Results: Bioinformatics analysis revealed that the expression of SPTSSA mRNA was higher in breast cancer tissues than that in adjacent normal tissues(P<0.001). KaplanMeier survival analysis showed that patients with higher SPTSSA expression had a shorter overall survival period than those with lower expression(P<0.001). The multi-immunohistochemical technique revealed that, compared with the normal tissues adjacent to the cancer, the expression of SPTSSA protein in breast cancer tissues was significantly increased( P=0.001). The Kaplan-Meier survival curve showed that patients with high expression of SPTSSA protein had a shorter overall survival time(P<0.0001). In the tumor area of breast cancer, high expression of SPTSSA protein was related to TNM stage(P=0.007) and lymph node metastasis(P=0.005), while high expression of SPTSSA protein was related to TNM stage in the stromal area(P=0.024). The univariate Cox regression analysis showed that the difference in the expression of SPTSSA between tumor cells and stromal cells was statistically significant(P<0.01). The tumor size(P=0.023), lymph node metastasis(P=0.002), distant metastasis(P=0.012), and TNM stage(P=0.001) were all related to the survival rate of patients. The multivariate Cox regression analysis showed that the expression of SPTSSA in tumor cells and stromal cells(P<0.001) and TNM stage(P<0.001) were related to the survival rate of patients. The multiple immunohistochemical experiments revealed that the expression of SPTSSA protein was significantly correlated with CD68~+CD163~+macrophages in the tumor area(r=0.234,P=0.01) and CD3~+CD4~+T cells in the stromal area(r=0.200, P=0.018). The expression of programmed death(PD1)(r=0.220,P=0.008) and cytotoxic T lymphocyte-associated antigen 4(CTLA-4)(r=0.225, P=0.007) was positively correlated with the SPTSSA level in the tumor area of breast cancer, but not related to the SPTSSA level in the stromal area. Conclusion: The expression of SPTSSA is sharply increased in breast cancer and is closely related to the prognosis of patients.
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基本信息:
DOI：10.19767/j.cnki.32-1412.2025.05.001
中图分类号:R737.9
引用信息:
[1]单佳俐,张丹,王庆庆.SPTSSA在乳腺癌中的表达及其预后意义[J].交通医学,2025,39(05):441-448.DOI:10.19767/j.cnki.32-1412.2025.05.001.
基金信息:
江苏省研究生科研与实践创新计划项目（SJCX23＿1796）