目的 探讨Rap1 GTP酶激活蛋白(Rap1GAP)在脑胶质瘤组织中的表达及其与临床病理特征和预后关系.方法 收集本院2011年1月至2016年12月手术切除并经病理证实的脑胶质瘤组织79例和正常脑组织33例,采用实时荧光定量PCR(QPCR)检测以上组织中的Rap1GAP mRNA水平,分析脑胶质瘤组织和正常脑组织中的Rap1GAP mRNA水平;分析脑胶质瘤不同临床病理特征(年龄、性别、病理类型、分化程度、病理分级、瘤周水肿和浸润深度)的Rap1GAP mRNA水平和分布情况,根据随访资料分析Rap1GAP mRNA水平与预后的关系.结果 脑胶质瘤组织的Rap1GAP mRNA水平为0.172±0.019,低于正常脑组织的1.068±0.069,差异有统计学意义(P＜0.05).Rap1GAP mRNA水平和分布与年龄、性别、瘤周水肿和浸润深度无关,但与病理类型、分化程度和病理分级有关(P＜0.05),在胶质母细胞瘤、低分化和Ⅲ、Ⅳ级脑胶质瘤组织的Rap1GAP mRNA水平和高表达率均较低,依次为0.104±0.006和27.0％(10/37)、0.099±0.006和16.1％(5/31)及0.127±0.007和39.3％(22/56).Rap1GAP低表达组的中位总生存期(OS)为14.5个月,低于高表达组的21.4个月(P＜0.05);胶质母细胞瘤、低分化和Ⅲ、Ⅳ级脑胶质瘤组织中,低表达组的中位OS分别为8.8、11.2和11.5个月,均低于高表达组的18.2、19.8和19.8个月(P＜0.05).结论 脑胶质瘤组织中Rap1GAP低表达参与了该肿瘤的发生发展,Rap1GAP低表达者的预后较差,提示Rap1GAP发挥类似抑癌基因的作用,可作为脑胶质瘤的治疗的候选基因.%Objective To investigate the expression of Rap1 GTPase activating protein (Rap1GAP) in glioma tissues and its relationship with clinicopathological features and prognosis.Methods From January 2011 to December 2016, 79 cases of glioma tissues and 33 cases of normal brain tissues surgical resected and confirmed by pathology were collected.Real-time fluorescence quantitative PCR (QPCR) was used to detect the mRNA level of Rap1GAP in the above tissues.The expression and distribution of Rap1GAP mRNA in different clinicopathological features of glioma (age, sex, pathological type, degree of differentiation, pathological grade, peritumoral edema and depth of invasion) were analyzed.The relationship between Rap1GAP mRNA level and prognosis was analyzed according to follow-up data.Results The mRNA level of Rap1GAP in glioma tissues was 0.172±0.019, lower than 1.068±0.069 in normal brain tissues (P＜0.05). The level and distribution of Rap1GAP mRNA were not correlated with age, sex, peritumoral edema and depth of invasion, but related with pathological type, differentiation degree and pathological grade (P＜0.05). The levels and highexpression rates of Rap1GAP mRNA were lower in glioblastoma, poorly differentiated and gradeⅢ/Ⅳglioma[0.104±0.006 and27.0％ (10/37), 0.099±0.006 and 16.1％ (5/31) and 0.127±0.007 and 39.3％ (22/56) ], respectively.The median overall survival (OS) was 14.5 months in the low-expression group, which was lower than 21.4 months in the high-expression group (P＜0.05). As for glioblastoma, poorly differentiated and gradeⅢ/Ⅳglioma tissues, the median OS was 8.8, 11.2 and 11.5 months in the lowexpression group, lower than 18.2, 19.8 and 19.8 months in the high-expression group (P＜0.05). Conclusion The low expression of Rap1GAP is involved in the occurrence and development of brain glioma, and the poor prognosis of Rap1GAP expression suggests that Rap1GAP may play a role similar to tumor suppressor gene and may be used as a candidate gene for the treatment of brain gliomas.
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