The Relationship Between BNIP3 Protein Expression And The Chemosensitivity Of Gemcitabine In Postoperative Pancreatic Cancer

Background Pancreatic cancer is a rapidly developing malignant tumor.The incidence rate of pancreatic cancer of rising year by year in our country.The prognosis of pancreatic cancer is poor.At present,surgical resection is still the treatment plan for radical treatment of pancreatic cancer.The survival rate of patients receiving surgery is also very low,which often prolongs life through postoperative adjuvant chemotherapy.Therefore,surgical resection and adjuvant chemotherapy are the first choice for pancreatic cancer.In the current adjuvant chemotherapy,gemcitabine or gemcitabine-based combination chemotherapy is more common.The survey found that the effect of this chemotherapy regimen in patients with pancreatic cancer is different.Some patients have little effect because of their low sensitivity to gemcitabine,which cannot further improve the quality of life,prolong the overall survival(OS)and disease-free survival(DFS),Bcl-2/adenovirus e1b-19kda-interacting protein 3(BNIP3)is a pro apoptotic protein interacting with adenovirus e1b19 kda,which can induce apoptosis and autophagy.This protein is closely related to tumor hypoxia and has a certain effect on tumor cells.In the absence of oxygen pathway,the key regulatory pathway of BNIP3 induced autophagy is related to the sensitivity of gemcitabine chemotherapy in pancreatic cancer.Some researchers have conducted some studies on the relationship between BNIP3 expression and the mechanism of gemcitabine chemotherapy resistance in pancreatic cancer after surgery.However,due to the influence of case selection,detection methods and population differences,the expression of BNIP3 in pancreatic cancer is low There is no consistent conclusion between the expression level and the sensitivity of gemcitabine chemotherapy.Objective This study aims to explore the relationship between the expression of BNIP3 in pancreatic cancer and the sensitivity of postoperative chemotherapy with gemcitabine,to explore the correlation between the protein expression level of BNIP3 and postoperative chemotherapy with gemcitabine.And to analyze whether the expression of BNIP3 protein can be used as a marker to predict the effect of gemcitabine chemotherapy after pancreatic cancer surgery.Method Choose to meet the criteria for the clinical patients,the general data and clinical information collection,select the corresponding pancreatic cancer tissue wax block of the selected patients.then carry on the BNIP3 expression protein immunohistochemical experiment and divide them into groups according to the staining intensity and staining range,make a score,and finally judge the expression of BNIP3 in pancreatic cancer by calculation.Through the follow-up of patients with prognosis,such as overall survival,disease-free survival,statistical analysis.To further analyze the relationship between the expression of BNIP3 levels in pancreatic cancer tissues and the overall survival and disease-free survival of patients,and to find independent factors affecting the prognosis of gemcitabine chemotherapy.And through qualitative and quantitative determination,to explore whether the general information and clinical data of patients will have an impact on the expression level of BNIP3 in pancreatic cancer.Results The median Overall Survival(OS)and Disease-Free Survival(DFS)of BNIP3 low-expression group and BNIP3 high-expression group were 18(95% CI16.592-19.408)months vs 13(95% CI 11.378-14.622)months,14(95% CI12.936-15.064)months vs 7(95% CI 4.082-9.938)months,respectively.The OS and DFS of BNIP3 low-expression group were higher than those of BNIP3high-expression group.The expression level of BNIP3 was associated with OS and DFS in patients receiving gemcitabine chemotherapy after pancreatic cancer surgery,and with postoperative survival time of patients with pancreatic cancer.BNIP3 expression level,tumor T stage and lymph node metastasis were independent influencing factors of OS;The expression level of BNIP3 and lymph node metastasis were independent influencing factors of DFS.There was no significant difference between the expression of BNIP3 and the general information of patients with pancreatic cancer,such as age,gender,nationality,tumor location,surgical method,tumor diameter and pathological differentiation(P>0.05).Conclusion The expression of BNIP3 in pancreatic cancer cells was correlated with the sensitivity of postoperative chemotherapy with gemcitabine.Patient with low expression of BNIP3 have higher OS and DFS expression after postoperative gemcitabine treatment and the effect of gemcitabine chemotherapy is better.At the same time,the expression level of BNIP3 was not correlated with age,gender,tumor location,surgical method,tumor diameter and degree of pathological differentiation of pancreatic cancer patients.However,the lymph node metastasis of pancreatic cancer and the expression of BNIP3 jointly affect OS and DFS.BNIP3 can be used as a marker to predict the efficacy of gemcitabine chemotherapy,which can help patients with pancreatic cancer to choose a more ideal individualized treatment program.