摘要
目的 探讨组织内缺氧诱导因子-1α(HIF-1α)、骨桥蛋白及血清血管内皮生长因子(VEGF)、糖类抗原19-9(CA19-9)水平与结直肠癌患者治疗后2年预后的关系.方法 选取2021年6月至2023年6月秦皇岛市第一医院收治的140例结直肠癌患者为观察组,另将同期于秦皇岛市第一医院体检的70名健康者为对照组.比较两组组织内HIF-1α、骨桥蛋白及血清VEGF、CA19-9表达情况;比较不同临床病理特征结直肠癌患者HIF-1α、骨桥蛋白、VEGF、CA19-9阳性检出率;以Kaplan-Meier法绘制HIF-1α、骨桥蛋白及血清VEGF、CA19-9阳性、阴性结直肠癌患者治疗后2年生存曲线.结果 观察组组织内HIF-1α、骨桥蛋白及血清VEGF、CA19-9阳性表达率分别为74.29％、58.57％、66.43％、45.00％,均显著高于对照组(20.00％、11.43％、35.71％、20.00％),差异均有统计学意义(P＜0.05).TNM分期Ⅲ～Ⅳ期、低分化、有淋巴结转移、有脉管浸润患者HIF-1α阳性检出率、CA19-9阳性检出率均明显高于TNM分期为Ⅰ～Ⅱ期、中高分化、无淋巴结转移、无脉管浸润患者,差异均有统计学意义(P＜0.05).肿瘤直径≥5 cm、TNM分期为Ⅲ～Ⅳ期、低分化、有脉管浸润患者骨桥蛋白阳性检出率均明显高于肿瘤直径＜5 cm、TNM分期为Ⅰ～Ⅱ期、中高分化、无脉管浸润患者,差异均有统计学意义(P＜0.05).TNM分期为Ⅲ～Ⅳ期、有淋巴结转移患者VEGF阳性检出率明显高于TNM分期为Ⅰ～Ⅱ期、无淋巴结转移患者,差异均有统计学意义(P＜0.05).Kaplan-Meier生存分析显示HIF-1α、骨桥蛋白、CA19-9阳性检出率越高患者治疗后2年存活率越低(Log-Rank=4.425、5.957、5.220,P=0.035、0.015、0.022);Kaplan-Meier生存分析显示VEGF阳性检出率与治疗后2年存活率无关(Log-Rank=0.032,P=0.858).(结论 组织内HIF-1α、骨桥蛋白及血清VEGF、CA19-9在结直肠癌中呈高表达水平,且HIF-1α、骨桥蛋白、CA19-9高表达与患者治疗后2年预后不良有关.
Abstract
Objective To investigate the relationships between the levels of hypoxia-induced-factor 1α(HIF-1α),osteopontin in tissue,serum vascular endothelial growth factor(VEGF)and carbohydrate antigen 19-9(CA19-9)and 2-year prognosis after treatment in patients with colorectal cancer.Methods A total of 140 patients with colorectal cancer admitted to Qinhuangdao First Hospital from June 2021 to June 2023 were retrospectively selected as the observation group,and 70 healthy subjects who underwent physical examination in our hospital dur-ing the same period were included as the control group.The expressions of HIF-1α,osteopontin in tissue and serum VEGF and CA19-9 were compared between the two groups;the positive rates of HIF-1α,osteopontin,VEGF and CA19-9 in colorectal cancer patients with different clinicopathological characteristics were compared;the 2-year after treatment survival curves of patients with HIF-1α,osteopontin,VEGF,CA19-9 positive and negative colorectal cancer were plotted by Kaplan-Meier method.Results The positive expression rates of HIF-1α,os-teopontin and serum VEGF and CA19-9 in observation group were 74.29％,58.57％,66.43％,and 45.00％,respectively,which were signif-icantly higher than those in the control group(20.00％,11.43％,35.71％,and 20.00％),and the differences were statistically significant(P＜0.05).The positive rates of HIF-1α and CA19-9 in patients with TNM stage Ⅲ-Ⅳ,poorly differentiated,lymph node metastasis and vascular infiltration were significantly higher than those in patients with TNM stage Ⅰ-Ⅱ,moderately well differentiated,no lymph node metasta-sis or vascular infiltration,and the differences were statistically significant(P＜0.05).The positive rates of osteopontin in patients with tumor di-ameter ≥5 cm,TNM stage Ⅲ-Ⅳ,low differentiation,and vascular infiltration were significantly higher than those in patients with tumor diameter＜5 cm,TNM stage Ⅰ-Ⅱ,medium to high differentiation,and no vascular infiltration,and the differences were statistically significant(P＜0.05).The positive rates of VEGF in patients with TNM stage Ⅲ-Ⅳ and lymph node metastasis were significantly higher than those in patients with TNM stage Ⅰ-Ⅱ,no lymph node metastasis,and the differences were statistically significant(P＜0.05).Kaplan-Meier survival analy-sis showed that the higher the positive rates of HIF-1α,osteopontin and CA19-9,the lower the survival rate of 2-year prognosis after treatment(Log-Rank=4.425,5.957,5.220;P=0.035,0.015,0.022).Kaplan-Meier survival analysis showed that the positive rate of VEGF was not correlated with survival rate of 2-year prognosis after treatment(Log-Rank=0.032,P=0.858).Conclusion HIF-1α,osteopontin in tissue and serum VEGF and CA19-9 are highly expressed in colorectal cancer,and the high expression of HIF-1α,osteopontin and CA19-9 is associated with poor 2-year prognosis after treatment.
基金项目
河北省卫生健康委医学科学计划(201902A137)
维普
万方数据