摘要
目的 分析不同TNM分期结直肠癌患者血清基质金属蛋白酶7(MMP7)、脱嘌呤脱嘧啶核酸内切酶1(APE1)、糖类抗原242(CA-242)表达差异及其与预后的相关性.方法 回顾性选取2018年4月至2022年4月延安大学附属医院收治的100例结直肠癌患者作为研究对象,根据TNM分期将患者分为Ⅰ～Ⅱ期组(n=42)、Ⅲ～Ⅳ期组(n=58);另将同期收治的50例结直肠良性增生患者纳入对照组.随访1年记录结直肠癌患者的生存率,将存活患者纳入预后良好组(n=83),另将死亡患者纳入预后不良组(n=17).检测所有患者的血清MMP7、APE1、CA-242水平.建立多因素Logistic模型分析TNM分期结直肠癌预后的影响因素,并分析血清MMP7、APE1、CA-242与不同TNM分期结直肠癌患者预后的相关性(双变量Spearman相关性法检验)及其预后预测价值.结果 Ⅰ～Ⅱ期患者血清MMP7、APE1、CA-242 水平分别为(32.54±3.65)µg/L、(0.39±0.04)ng/mL、(22.54±3.54)U/mL,Ⅲ～Ⅳ 期患者血清 MMP7、APE1、CA-242 水平分别为(42.84±3.84)μg/L、(0.54±0.05)ng/mL、(42.16±4.35)U/mL,均高于对照组[(20.65±2.45)μg/L、(0.21±0.02)ng/mL、(8.24±1.12)U/mL],差异均有统计学意义(P＜0.05). 预后不良组患者血清 MMP7、APE1、CA-242 水平分别为(41.58±3.58)μg/L、(0.52±0.04)ng/mL、(40.25±4.12)U/mL,均高于预后良好组[(33.24±3.41)μg/L、(0.41±0.04)ng/mL、(23.46±3.61)U/mL],差异均有统计学意义(P＜0.05).多因素Logistic分析结果显示,TNM分期、MMP7、APE1、CA-242均为影响结直肠癌预后的独立危险因素(P＜0.05).血清 MMP7、APE1、CA-242 与 Ⅰ～Ⅱ 期、Ⅲ～Ⅳ期预后不良均呈正相关(P＜0.05).血清 MMP7、APE1、CA-242 与MMP7+APE1+CA-242肺癌化疗预后预测中的曲线下面积均大于0.75.结论 血清MMP7、APE1及CA-242在结直肠癌中均呈高表达,且与病情进展及其预后存在一定关联,可为治疗方案的指导和预后的预测提供科学的参考依据.
Abstract
Objective To analyze the expression differences of serum matrix metalloproteinase 7(MMP7),apurinic apyrimidinic endonu-clease 1(APE1),and carbohydrate antigen 242(CA-242)in colorectal cancer patients with different TNM stages and their correlation with prognosis.Methods A total of 100 patients with colorectal cancer admitted to the Affiliated Hospital of Yan'an University from April 2018 to April 2022 were retrospectively selected as the study subjects.According to TNM staging,the patients were divided into stage Ⅰ-Ⅱ groups(n=42)and stage Ⅲ-Ⅳ groups(n=58).Another 50 patients with colorectal benign hyperplasia admitted during the same period were included in the control group.The survival rate of colorectal cancer patients was recorded during 1-year follow-up,surviving patients were included in the group with good prognosis(n=83),and deceased patients were included in the group with poor prognosis(n=17).Serum MMP7,APE1 and CA-242 levels of all patients were detected,and a multivariate Logistic model was established to analyze the factors affecting the prognosis of TNM stage colorectal cancer.The correlation between serum MMP7,APE1,CA-242 and prognosis of colorectal cancer patients with different TNM stages(bivariate Spearman correlation test)and its prognotic value were analyzed.Results The levels of serum MMP7,APE1,and CA-242 in pa-tients with stage Ⅰ-Ⅱ were(32.54±3.65)µg/L,(0.39±0.04)ng/mL,(22.54±3.54)U/mL,respectively,and the levels of serum MMP7,APE1,and CA-242 in stage Ⅲ-Ⅳ patients were(42.84±3.84)μg/L,(0.54±0.05)ng/mL,(42.16±4.35)U/mL,respec-tively,which were higher than those in the control group[(20.65±2.45)µg/L,(0.21±0.02)ng/mL,(8.24±1.12)U/mL],the differ-ences were statistically significant(P＜0.05).The levels of serum MMP7,APE1 and CA-242 in the poor prognosis group were(41.58±3.58)μg/L,(0.52±0.04)ng/mL,(40.25±4.12)U/mL,respectively,which were higher than those in the good prognosis group[(33.24±3.41)μg/L,(0.41±0.04)ng/mL,(23.46±3.61)U/mL],and the differences were statistically significant(P＜0.05).Multivariate logistic a-nalysis showed that TNM stage,MMP7,APE1 and CA-242 were independent risk factors for the prognosis of colorectal cancer(P＜0.05).Se-rum MMP7,APE1 and CA-242 were positively correlated with poor prognosis in stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ(P＜0.05).The area under the curve of serum MMP7,APE1,CA-242 and MMP7+APE1+CA-242 in prognosis prediction of lung cancer chemotherapy were greater than 0.75.Conclusion Serum MMP7,APE1,and CA-242 are highly expressed in colorectal cancer and are associated with disease progression and prognosis,providing scientific reference for guiding treatment plans and predicting prognosis.
基金项目
陕西省医学科学研究重点课题(2019JM0998)
维普
万方数据