摘要
目的 探索血管瘤患儿血清粒细胞-巨噬细胞集落刺激因子(GM-CSF)及转录激活因子3(STAT3)的表达水平并分析其与瘤体增生的相关性.方法 选取2020年1月—2023年1月收治的152例血管瘤增生患儿作为研究对象,分为增生期组(87例)与退化期组(65例),另选择同期确诊为血管畸形的53例患儿作为血管畸形组.对血清GM-CSF、STAT3及碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)、缺氧诱导因子-1α(HIF-1α)、血管生成素-1(Ang-1)的表达水平进行检测;Pearson法相关性分析血清GM-CSF、STAT3与bFGF、VEGF、HIF-1α、Ang-1的相关性;受试者工作特征(ROC)曲线分析血清GM-CSF、STAT3对血管瘤瘤体增生的预测价值;多因素Logistic回归分析血管瘤瘤体增生的影响因素.结果 增生期组患儿血清bFGF、VEGF、HIF-1α、GM-CSF、STAT3表达水平高于血管畸形组及退化期组患儿(P＜0.05),但血清Ang-1表达水平低于血管畸形组及退化期组患儿(P＜0.05);Pearson法相关性分析显示,增生期组患儿血清GM-CSF及STAT3水平均与bFGF、VEGF、HIF-1α水平正相关,与Ang-1水平负相关;ROC曲线下面积显示,GM-CSF和STAT3单独预测血管瘤瘤体增生风险的AUC分别为0.847,0.822,联合预测的AUC为0.918,联合预测的效能显著大于GM-CSF单独诊断的AUC(Z=2.459,P=0.014),STAT3单独诊断的AUC(Z=3.371,P=0.001).多因素Logistic回归分析显示GM-CSF、STAT3是血管瘤瘤体增生的影响因素(P＜0.05).结论 血管瘤瘤体增生患儿血清GM-CSF及STAT3表达水平升高,是瘤体增生的影响因素,联合检测能较好的预测血管瘤瘤体增生风险.
Abstract
Objective To explore the expression levels of granulocyte-macrophage colony stimulating factor(GM-CSF)and transcription activating factor 3(STAT3)in serum of children with vascular tumor and analyze their correlation with tumor proliferation.Methods From January 2020 to January 2023,152 children with vascular tumor hyperplasia were divided into a proliferative stage group(87 cases)and a degenerative stage group(65 cases),another 53 children with vascular malformations were collected as the vascular malformation group.The expression levels of serum GM-CSF,STAT3,basic fibroblast growth factor(bFGF),vascular endothelial growth factor(VEGF),hypoxia inducible factor-1α(HIF-1α),and angiopoietin-1(Ang-1)were detected;Pearson correlation method was applied to analyze the correlation between serum GM-CSF,STAT3,bFGF,VEGF,HIF-1α,Ang-1;receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum GM-CSF and STAT3 for the vascular tumor proliferation;multivariate Logistic regression was applied to analyze the influencing factors of vascular tumor proliferation.Results The expression levels of bFGF,VEGF,HIF-1α,GM-CSF,and STAT3 in the serum of children in the proliferative stage group were higher than those in the vascular malformation group and degenerative stage group(P＜0.05),but the expression level of Ang-1 in the serum was lower than that in the vascular malformation group and degenerative stage group(P＜0.05);Pearson correlation analysis showed that the serum levels of GM-CSF and STAT3 in the proliferative stage group were positively correlated with bFGF,VEGF,HIF-1αlevels,and negatively correlated with Ang-1 level.The area under the ROC curve showed that the AUC of GM-CSF and STAT3 alone predicting the risk of vascular tumor proliferation was 0.847,0.822 respectively,and the AUC of the combined prediction was 0.918,the effectiveness of joint prediction was obviously greater than that of AUC diagnosed by GM-CSF alone(Z=2.459,P=0.014),and AUC diagnosed by STAT3 alone(Z=3.371,P=0.001).Multivariate Logistic regression analysis showed that GM-CSF and STAT3 were the influencing factors for the proliferation of vascular tumor(P＜0.05).Conclusions The expression levels of serum GM-CSF and STAT3 are elevated in children with vascular tumor proliferation,and it is a factor affecting tumor proliferation,combined detection can effectively predict the risk of vascular tumor proliferation.
维普
万方数据