Dynamin 3在胃癌中的作用机制及预后价值

The mechanism of action and prognostic value of Dynamin 3 in gastric cancer

  • 摘要:
    目的 探讨Dynamin 3(DNM3)在胃癌中的作用机制及预后价值。
    方法 采用生物信息分析、实验研究方法和回顾性队列研究方法。收集2013年1月至2018年7月福建医科大学附属协和医院收治的153例行根治性胃切除术胃癌患者的临床病理资料、新鲜胃癌及配对正常组织样本和石蜡切片,行实时荧光定量聚合酶链式反应检测、免疫印迹实验、流式细胞周期实验、免疫组织化学染色检测和预后分析。收集癌症基因组图谱(TCGA)数据库的胃腺癌(STAD)数据集进行生物信息分析。观察指标:(1)胃癌中DNM3基因在TCGA‑STAD中的表达情况。(2)胃癌中DNM3的突变和拷贝数改变。(3)胃癌中DNM3的启动子甲基化水平。(4)胃癌中DNM3、p53的蛋白相对表达量。(5)胃癌中DNM3相关性和富集性分析。(6)流式细胞周期G0/G1期、S期、G2/M期的比例。(7)胃癌中免疫细胞浸润和DNM3之间的相关性。(8)免疫组织化学染色检测与临床特征之间的相关性。(9)影响胃癌患者5年总生存率的独立因素分析。正态分布的计量资料以x±s表示,多组间比较采用方差分析,进一步两两比较采用LSD法;两组间比较采用t检验;偏态分布的计量资料以MQ1,Q3)表示,组间比较采用Mann⁃Whitney U检验。计数资料以绝对数或百分比表示,组间比较采用χ²检验或Fisher确切概率法。配对样本采用威尔科克森符号秩检验。等级资料采用秩和检验。运用Pearson相关系数或Spearman相关系数检验两组的相关性。单因素和多因素分析采用COX比例风险回归模型。采用Kaplan‑Meier法绘制生存曲线并计算生存率,采用Log‑Rank检验进行生存情况分析。使用Benjamini‑Hochberg错误发生率校正对P值进行调整。
    结果 (1)胃癌中DNM3基因在TCGA‑STAD中的表达情况。TCGA‑STAD数据库中DNM3基因在27个肿瘤组织和配对正常组织中的表达水平分别为0.775(0.605,1.161)和1.216(0.772,1.681),两者比较,差异有统计学意义(Z=-2.64,P<0.05)。DNM3基因在笔者中心48对胃癌组织和配对正常组织中mRNA表达水平分别为4.370(2.870,6.040)和2.520(0.850,4.170),两者比较,差异有统计学意义(Z=-4.39,P<0.05)。(2)胃癌中DNM3的突变和拷贝数改变。TCGA‑STAD数据库中16例胃癌患者发生DNM3突变或体细胞拷贝数改变,其中6个错义突变,1个截断突变,8个拷贝数增加,1个拷贝数减少。TCGA‑STAD数据库370例胃癌患者中DNM3突变前后的mRNA表达水平分别为6.13(5.40,7.08)和5.02(3.98,5.46),两者比较,差异有统计学意义(Log2FC=-1.11,Z=-2.59,P<0.05)。(3)胃癌中DNM3的启动子甲基化水平。TCGA⁃STAD数据库中372例胃癌患者DNM3甲基化水平与DNM3 mRNA的检测结果显示:DNM3甲基化水平为0.198(-0.458,0.301),DNM3 mRNA表达水平为6.014(5.141,6.628),DNM3甲基化水平与DNM3 mRNA表达水平呈负相关(r=-0.38,P<0.05)。32例患者随访结果显示:16例DNM3高甲基化组和16例DNM3低甲基化组患者3年总生存率分别为18.8%和41.3%,两者比较,差异有统计学意义(风险比=1.40,P<0.05)。免疫印迹实验结果显示:AGS细胞用0、0.5、1.0 μmol/L 5‑azacytidin处理后的DNM3相对表达量分别为0.270±0.020、0.357±0.051、0.599±0.039,3组比较,差异有统计学意义(F=57.84,P<0.05)。HGC⁃27细胞用0、0.5、1.0 μmol/L 5‑azacytidin处理后的DNM3相对表达量分别为0.316±0.038、0.770±0.031、0.877±0.052,3组比较,差异有统计学意义(F=156.30,P<0.05)。(4)胃癌中DNM3、p53的蛋白相对表达量。免疫印迹实验结果显示:转染DNM3质粒和对照质粒的AGS细胞中DNM3、p53的蛋白相对表达量分别为0.688±0.047、0.872±0.041和0.249±0.029、0.352±0.020;转染DNM3质粒和对照质粒的AGS细胞比较,上述蛋白相对表达量差异均有统计学意义(t=13.77,19.74,P<0.05)。转染DNM3质粒和对照质粒的HGC⁃27细胞中上述蛋白相对表达量分别为0.969±0.069、1.464±0.081和0.456±0.048、0.794±0.052,差异均有统计学意义(t=10.57,12.06,P<0.05)。(5)胃癌中DNM3相关性和富集性分析。相关性分析结果显示:DNM3与胃癌中RBMS3、CNTN4、PDE1A基因呈正相关(r=0.52,0.52,0.50,P<0.05),与SLC25A39、PAICS、GAPDH基因呈负相关(r=-0.41,-0.40,-0.40,P<0.05)。基因集富集分析结果显示:与核糖体和氧化磷酸化有关的基因集在DNM3低表达组中上调富集分数(NES)=-3.30,-2.16,P<0.05,而淋巴细胞和非淋巴细胞之间的免疫调节相互作用在DNM3高表达组中上调(NES=1.67,P<0.05)。基因本体论分析结果显示:DNM3低表达与有丝分裂姐妹染色体分离(编号:0000070)、无义介导衰变的核转录mRNA分解过程、姐妹染色体分离(编号:0000819)、核转录mRNA分解代谢过程、氧化磷酸化的调控有关(NES=-2.29,-3.10,-2.33,-2.56,-2.68,P<0.05)。京都基因与基因组百科全书分析结果显示:DNM3低表达在核糖体和氧化磷酸化中存在上调和串联(NES=-3.34,-2.21,P<0.05)。(6)流式细胞周期G0/G1期、S期、G2/M期的比例。流式细胞周期实验结果显示:转染pCMV⁃DNM3质粒的AGS细胞G0/G1期、S期、G2/M期的比例分别为65.1%±3.0%、17.3%±3.0%、17.6%±1.0%,转染对照质粒的AGS细胞上述指标分别为53.4%±4.0%、26.3%±2.0%、20.3%±3.0%。转染DNM3质粒与转染对照质粒的AGS细胞比较,G0/G1期、S期差异均有统计学意义(t=4.05,4.32,P<0.05)。(7)胃癌中免疫细胞浸润和DNM3之间的相关性。免疫细胞浸润实验结果显示:DNM3 mRNA表达水平与肥大细胞,NK细胞,pDCs,B细胞,滤泡辅助T细胞,有效记忆T细胞,T细胞,中央记忆T细胞,CD8 T细胞,DC细胞,巨噬细胞,γ⁃δT细胞(Tgd),iDCs,嗜酸性粒细胞浸润水平呈正相关(Spearman相关系数分别为0.41,0.29,0.26,0.20,0.22,0.22,0.13,0.16,0.15,0.14,0.14,0.17,0.18,0.22,P<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,P=0.015,0.002,0.004,0.005,0.005,P<0.001,<0.001,<0.001);与Th17细胞,Th2细胞,NK CD56dim细胞浸润水平呈负相关(r=-0.18,-0.23,-0.10,P<0.001,P=0.001和P=0.046)。(8)免疫组织化学染色检测与临床特征之间的相关性。免疫组织化学分析结果显示:DNM3在105例胃癌组织和105例配对正常组织中的免疫组织化学染色评分分别为3(2,4)分和6(4,9)分,差异有统计学意义(Z=-7.35,P<0.05)。70例DNM3低表达与35例DNM3高表达胃癌患者性别、肿瘤部位、N分期比较,差异均有统计学意义(χ²=4.29,7.67,6.86,P<0.05)。(9)影响胃癌患者5年总生存率的独立因素分析。多因素分析结果显示:病理学T分期为T3~4期和DNM3染色评分低是胃癌患者5年总生存率的独立危险因素(风险比=1.91,0.51,95%可信区间为1.06~3.43,0.26~0.98,P<0.05)。DNM3低表达组胃癌患者和高表达组胃癌患者的5年总生存率分别为44.3%和65.7%,两者比较,差异有统计学意义(χ²=5.02,P<0.05)。
    结论 DNM3是一种肿瘤抑制因子,也是胃癌预后不良的独立预测因子,它可能通过甲基化调控胃癌的细胞周期和肿瘤微环境中的免疫抑制。

     

    Abstract:
    Objective To investigate the mechanism of action and prognostic value of Dynamin 3 (DNM3) in gastric cancer.
    Methods The bioinformatic analysis, experimental study and retrospective cohort study was conducted. The clinicopathological data, fresh gastric cancer tissues, paired normal tissues and the corresponding paraffin sections of 153 gastric cancer patients who underwent radical gastrectomy in Fujian Medical University Union Hospital from January 2013 to July 2018 were collected. Tissues and the corresponding paraffin sections were subjected to quanti-tative real‑time polymerase chain reaction, immunoblotting assay, flow cytometric cell cycle assay and immunohistochemical staining, respectively, and clinicopathological data were used for prognostic analysis. The stomach adenocarcinoma (STAD) dataset from the Cancer Genome Atlas (TCGA) database was collected for bioinformatic analysis. Observation indicators: (1) DNM3 gene expression in TCGA-STAD in gastric cancer; (2) mutations and copy number alterations of DNM3 in gastric cancer; (3) methylation level of promoter of DNM3 in gastric cancer; (4) relative protein expression of DNM3 and p53 in gastric cancer; (5) DNM3 correlation and enrichment analysis; (6) ratio of G0/G1 phase, S phase and G2/M phase of cell cycle progression; (7) correlation between immune cell infiltration and DNM3 in gastric cancer; (8) correlation between results of immunohistochemical (IHC) staining and clinical features; (9) analysis of independent factors influencing 5-year overall survival rate of gastric cancer patients. Measurement data with normal distribution were represented as Mean±SD, and comparison among multiple groups was conducted using the ANOVA and further comparison between two groups was conducted using the LSD. Comparison between two groups was conducted using the t test. Measurement data with skewed distribution were represented as M(Q1,Q3), and comparison between groups was conducted using the Mann‑Whitney U test. Count data were described as absolute numbers or percentages, and compari-son between groups was conducted using the chi‑square test or Fisher exact probability. Comparison of ordinal data was conducted using the rank sum test. The Pearson correlation coefficient or Spearman correlation coefficient was used to test the correlation between groups. Univariate and multivariate analyses were conducted using the COX proportional risk regression model. The Kaplan‑Meier method was used to draw survival curves and calculate survival rates, and the Log‑Rank test was used for survival analysis. The Benjamini-Hochberg false discovery rate correction was used for adjusting of the P‑value.
    Results (1) DNM3 gene expression in TCGA‑STAD. The expression levels of DNM3 gene in the 27 tumor tissues and paired normal tissues of the TCGA‑STAD database were 0.775(0.605,1.161) and 1.216(0.772,1.681), showing a significant difference between them (Z=‒2.64, P<0.05). The messenger RNA (mRNA) expression levels of DNM3 gene in 48 pairs of gastric cancer tissues and paired normal tissues of the author′s center were 4.370(2.870,6.040) and 2.520(0.850,4.170), showing a significant difference between them (Z=‒4.39, P<0.05). (2) Mutations and copy number alterations of DNM3 in gastric cancer. There were 16 gastric cancer patients in the TCGA‑STAD database with DNM3 mutation or somatic copy number alterations, including 6 cases with missense mutations, 1 case with truncated mutation, 8 cases with copy number gain and 1 case with copy number loss. The mRNA expression levels of DNM3 gene before and after mutation in the 370 gastric cancer patients of the TCGA‑STAD database were 6.13(5.40,7.08) and 5.02(3.98,5.46), showing a significant difference between them (Log2FC=‒1.11, Z=‒2.59, P<0.05). (3) Methylation level of promoter of DNM3 in gastric cancer. There were 372 gastric cancer patients in the TCGA‑STAD database undergoing DNM3 methylation and mRNA examinations, and the results showed that levels of methylation and mRNA expression of DNM3 was 0.198 (-0.458, 0.301) and 6.014 (5.141, 6.628), respectively. The levels of methylation in DNM3 was negatively correlated with its mRNA expression (r=‒0.38, P<0.05). Results of follow-up in 32 patients showed that the 3‑year overall survival rate of 16 cases with high levels of methylation in DNM3 and 16 cases with low levels of methylation in DNM3 was 18.8% and 41.3%, respectively, showing a significant difference between them (hazard ratio=1.40, P<0.05). Results of immunoblot-ting assay showed that the relative expression level of DNM3 protein in the AGS cells treated with 0, 0.5, and 1.0 μmol/L of 5‑azacytidin was 0.270±0.020, 0.357±0.051 and 0.599±0.039, respectively, showing a significant difference among the three groups (F=57.84, P<0.05). The relative expression level of DNM3 protein in the HGC-27 cells treated with 0, 0.5, and 1.0 μmol/L of 5‑azacytidin was 0.316±0.038, 0.770±0.031 and 0.877±0.052, respectively, showing a significant difference among the three groups (F=156.30, P<0.05). (4) Relative protein expression of DNM3 and p53 in gastric cancer. Results of immunoblotting assay showed that the relative expression of DNM3 and p53 protein was 0.688±0.047 and 0.872±0.041 in the AGS cells transfected with pCMV‑DNM3 plasmid, versus 0.249±0.029 and 0.352±0.020 in the AGS cells transfected with control plasmid, showing significant differences in the above indicators between the two types of cells (t=13.77,19.74, P<0.05). The relative expression of DNM3 and p53 protein was 0.969±0.069 and 1.464±0.081 in the HGC-27 cells transfected with pCMV‑DNM3 plasmid, versus 0.456±0.048 and 0.794±0.052 in the HGC-27 cells transfected with control plasmid, showing significant differences in the above indicators between the two types of cells (t=10.57, 12.06, P<0.05). (5) DNM3 correlation and enrichment analysis. Results of correlation analysis showed that DNM3 was positively correlated with genes such as RBMS3, CNTN4 and PDE1A (r=0.52, 0.52, 0.50, P<0.05) and negatively correlated with genes such as SLC25A39, PAICS and GAPDH (r=‒0.41, ‒0.40, ‒0.40, P<0.05) in gastric cancer. Results of gene set enrichment analysis showed that the set of genes related to ribosome and oxidative phosphorylation were upregulated in gastric cancer patients with DNM3 low expression normalized enrichment score (NES)=‒3.30, ‒2.16, P<0.05, while the set of genes related to immunomodulatory interactions between lymphocytes and non‑lymphoid cells were upregulated in gastric cancer patients with DNM3 high expression (NES=1.67, P<0.05). Results of gene ontology analysis showed that the low expression of DNM3 was associated with the separation of mitotic sister chromatid (No.0000070), nonsense‑mediation of nuclear transcriptional mRNA catabolic process, sister chromatid separation (No.0000819), nuclear transcriptional mRNA catabolic process and regulation of oxidative phos-phorylation (NES=‒2.29, ‒3.10, ‒2.33, ‒2.56, ‒2.68, P<0.05). Results of Kyoto encycl opedia of genes and genomes analysis showed that metabolic pathway related to ribosome and oxidative phosphory-lation were upregulated and crosstalked in gastric cancer with low expression of DNM3 (NES=‒3.34, ‒2.21, P<0.05). (6) Ratio of G0/G1 phase, S phase and G2/M phase of cell cycle progression. Results of flow cytometric cell cycle experiments showed that the proportions of G0/G1 phase, S phase and G2/M phase in the cell cycle was 65.1%±3.0%, 17.3%±3.0% and 17.6%±1.0% in the AGS cells transfected with pCMV-DNM3 plasmid, versus 53.4%±4.0%, 26.3%±2.0% and 20.3%±3.0% in the AGS cells transfected with control plasmid, showing significant differences in the proportions of G0/G1 phase and S phase in the two types of cells (t=4.05, 4.32, P<0.05). (7) Correlation between immune cell infiltration and DNM3 in gastric cancer. Results of immune cell infiltration examination showed that the expression level of DNM3 was positively associated with mast cells, NK cells, pDCs, B cells, follicular helper T cells, effector memory T cells, T cells, central memory T cells, CD8 T cells, DC cells, macrophages, γ‑δ T cells (Tgd), iDCs and eosinophils infiltration (Spearman correlation coefficients as 0.41, 0.29, 0.26, 0.20, 0.22, 0.22, 0.13, 0.16, 0.15, 0.14, 0.14, 0.17, 0.18, 0.22, P<0.05) and negatively associated with Th17 cell, Th2 cells and NK CD56 dim cells infiltration (r=‒0.18, ‒0.23, ‒0.10, P<0.05). (8) Correlation between results of IHC staining and clinical features. Results of IHC staining analysis showed that the IHC score of DNM3 was 3(2,4) in the 105 gastric cancer tissues, versus 6(4,9) in the 105 paired normal tissues, showing a significant difference between them (Z=-7.35, P<0.05). There were significant differences in gender, tumor location and N stating between the 70 patients with low expression of DNM3 and the 35 patients with high expression of DNM3 (χ²=4.29, 7.67, 6.86, P<0.05). (9) Analysis of independent factors influencing 5-year overall survival rate of gastric cancer patients. Results of multivariate analysis showed that stage pT3‒4 and low IHC score of DNM3 were independent risk factors for 5‑year overall survival rate of gastric cancer patients (hazard ratio=1.91, 0.51, 95% confidence interval as 1.06‒3.43, 0.26‒0.98, P<0.05). The 5‑year overall survival rate was 44.3% in patients with low expression of DNM3, versus 65.7% in gastric cancer patients with high expression of DNM3, showing a significant difference between them (χ²=5.02, P<0.05).
    Conclusion DNM3 is a tumor suppressor and an independent predictor of poor prognosis for gastric cancer, which may regulate gastric cancer cell cycle and immunosuppression in the tumor microenvironment through methylation.

     

/

返回文章
返回