Expression and clinical significance of serum IGF-1,MCP-1 and ET-1 in acute respiratory distress syndrome after esophageal cancer surgery
Objective To analyze the expression and clinical significance of insulin-like growth factor 1(IGF-1),monocyte chemoattractant protein-1(MCP-1)and endothelin-1(ET-1)in patients with acute respiratory distress syndrome(ARDS)after esophageal cancer surgery. Methods From December 2020 to May 2022,256 patients with esophageal cancer were selected and divided into two groups:the non-ARDS group(194 cases)and the ARDS group(62 cases)based on the occurrence of ARDS after the operation. The levels of serum IGF-1,MCP-1 and ET-1 were compared between the non-ARDS and ARDS groups. The lev-els of serum IGF-1,MCP-1 and ET-1 were compared at different time points after the operation within the AR-DS group. Furthermore,the levels of serum IGF-1,MCP-1,ET-1 and APACHEⅡscore were compared with the ARDS group. Pearson correlation analysis was used to examine the relationship between serum IGF-1, MCP-1,ET-1 levels and APACHEⅡscore. Moreover,the ROC curves were drawn to analyze the predictive value of IGF-1 ,MCP-1 and ET-1 detection alone or in combination after ARDS for esophageal cancer. Results Serum levels of IGF-1,MCP-1 and ET-1 in the ARDS group were significantly higher than those in the non-ARDS group,and the difference was statistically significant(P<0.05). The comparison of serum IGF-1, MCP-1 and ET-1 levels showed that 7 days after surgery>4 days>1 day after surgery,with a statistically sig-nificant difference(P<0.05). The comparison of serum IGF-1,MCP-1,ET-1 levels,and APACHEⅡscores indicated that the severe group >moderate group >mild group,with a statistically significant difference(P<0.05). Serum levels of IGF-1,MCP-1 and ET-1 were positively correlated with APACHEⅡscores(P<0.05). The sensitivity,specificity,and AUC(95％ CI)of the combined detection of IGF-1,MCP-1 and ET-1 for ARDS after esophageal cancer surgery were 93.27％,90.05％and 0.811(0.774～0.932)respectively. All these values were higher than the above indicators(P<0.05). Conclusion The levels of serum IGF-1,MCP-1 and ET-1 are elevated in patients with ARDS following esophageal cancer surgery. This increase is associated with the development of ARDS and could serve as a marker for evaluating both the occurrence and severity of AR-DS post-surgery. Additionally,the combined measurement of all three markers may be more valuable in pre-dicting the likelihood of ARDS after esophageal cancer surgery.
万方数据
维普
