[摘 要] 目的：探究聚丝蛋白（FLG）在黑色素瘤组织中的表达及其与患者临床病理特征、预后的关系。方法：选取2019年6 月至2020年8月间山东第一医科大学附属人民医院收治的70例黑色素瘤患者为研究对象，取术中切除的瘤组织及瘤旁组织标 本，用免疫组织化学法检测FLG蛋白表达，根据FLG的表达将患者分为阳性组和阴性组，比较瘤组织、瘤旁组织及不同病理特征 下黑色素瘤组织中FLG的阳性表达率。随访患者3年，根据患者预后情况将患者分为生存组（n = 43）和死亡组（n = 27），比较两 组患者的FLG阳性表达率，采用Kaplan-Meier法绘制生存曲线，比较两组患者生存时间。结果：黑色素瘤组织中FLG表达阳性 率显著低于瘤旁组织（P < 0.05）；FLG阳性组肿瘤直径 > 1 cm、Breslow厚度 > 2 mm、局部溃疡、TNM分级Ⅲ～Ⅳ级、淋巴结转移、 肿瘤侵袭占比显著低于阴性组（P < 0.05或P < 0.01）；70例患者中死亡27例，生存43例，生存率61.42%，死亡组患者FLG表达阳 性率显著低于生存组（P < 0.05），FLG表达阳性患者生存时间显著长于阴性患者（P = 0.010）；多因素Cox回归分析显示，Breslow 厚度 > 2 mm、TNM分级Ⅲ～Ⅳ级、淋巴结转移、肿瘤侵袭是影响黑色素瘤患者预后的危险因素（P < 0.01或P < 0.001），FLG表达阳 性为保护因素（P < 0.01或P < 0.001）。结论：黑色素瘤组织中FLG显著降低，且与肿瘤Breslow厚度、分期侵袭和淋巴结转移等 病理特征及预后有关。

[Abstract] Objective: To explore the expression of filaggrin (FLG) in melanoma tissues and its correlation with clinicopathological features and prognosis in patients. Methods: A total of 70 melanoma patients treated at the People’ s Hospital Affiliated to Shandong First Medical University from June 2019 to August 2020 were selected as research subjects. Tumor tissues and adjacent tissues obtained during surgery were examined for FLG expression using immunohistochemistry. Based on FLG expression, patients were divided into a positive group and a negative group. The positive expression rates of FLG in tumor tissues, adjacent tissues and melanoma tissues with different pathological features were compared. The patients were followed up for 3 years, and based on prognosis, they were divided into a survival group (n = 43) and a death group (n = 27). The FLG positive expression rates were compared between the two groups. Kaplan-Meier survival curves were plotted, and survival times were compared. Results: The positive FLG expression rate in melanoma tissues was significantly lower than that in adjacent tissues (P < 0.05). The proportions of patients with tumor diameter > 1 cm, Breslow thickness > 2 mm, local ulcer, TNM stage Ⅲ-Ⅳ, lymph node metastasis, and tumor invasion in positive FLG expression group were significantly lower than those in negative group (P < 0.05 or P < 0.01). Among the 70 patients, 27 cases died and 43 survived, with a survival rate of 61.42%. The positive FLG expression rate was significantly lower in death group than that in survival group (P < 0.05). The survival time of FLG-positive patients was significantly longer than that of FLG-negative patients (P = 0.010). Multivariate Cox regression analysis revealed that Breslow thickness > 2 mm, TNM grade Ⅲ-Ⅳ, lymph node metastasis, and tumor invasion were risk factors for the prognosis of melanoma patients (P < 0.01 or P < 0.001), while positive FLG expression was a protective factor (P < 0.01 or P < 0.001). Conclusion: FLG expression is significantly decreased in melanoma tissues and is associated with pathological features such as Breslow thickness, tumor stage, invasion, lymph node metastasis, and prognosis.

济南市卫生健康委员会科技计划项目（No.2024101001）