胃腺癌患者外周血中基质细胞衍生因子-1α含量检测及其临床意义  

Content of Stromal Cell Derived Factor-1α in Peripheral Blood of Patients with Gastric Adenocarcinoma and Its Clinical Significances

作　　者：王路兵[1,2] 朱登峰[2] 黄磊[2] 张超峰[2] 姜波健[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院普外科,上海201900 [2]上海交通大学医学院附属新华医院崇明分院普外科,上海202150

出　　处：《中国普外基础与临床杂志》2015年第11期1327-1331,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：上海市崇明县卫生局科研项目(编号:CW2013-08)~~

摘　　要：目的检测胃腺癌患者血清中基质细胞衍生因子-1α（SDF-1α）含量及探讨其临床意义。方法应用酶联免疫吸附法检测胃腺癌患者血清中SDF-1α含量,分析其与胃腺癌患者临床病理特征及预后的关系。结果1胃腺癌患者血清SDF-1α含量〔n=90,（6 950.8±1 131.3）ng/L〕明显高于健康自愿者〔n=25,（5 023.7±1 103.8）ng/L〕,差异有统计学意义（P=0.036）。2发生远处转移的胃腺癌患者（n=12）血清SDF-1α含量〔（8 251.6±1 042.5）ng/L〕明显高于未发生远处转移患者〔n=78,（6 785.3±1 025.0）ng/L〕,差异有统计学意义（P〈0.001）。发生肝转移（P=0.002）和肺转移（P=0.030）的患者外周血中SDF-1α含量也均分别明显高于相应未发生转移的患者。3胃腺癌患者肿瘤TNM分期较晚（P〈0.001）、淋巴结转移更为广泛（P=0.018）、肿瘤浸润较深（P〈0.001）、存在血管侵犯（P〈0.001）及淋巴管侵犯（P〈0.001）的胃腺癌患者的血清中SDF-1α含量明显升高。logistic回归分析结果提示,肿瘤浸润深度（OR=14.999,95%可信区间为3.568~74.456,P=0.027）和有远处转移（OR=0.186,95%可信区间为0.610~2.014,P=0.026）与胃腺癌患者血清中SDF-1α含量升高有关。4外周血中SDF-1α高表达患者的术后生存时间明显短于SDF-1α低表达患者（P〈0.001）。Cox比例风险回归模型分析提示肿瘤分期（RR=2.497,95%可信区间为1.987~10.238,P=0.009）、血管侵犯程度（RR=7.501,95%可信区间为2.086~16.942,P=0.002）及外周血中SDF-1α含量（RR=18.302,95%可信区间为6.895~30.538,P=0.001）是影响胃腺癌患者预后的独立危险因素。结论胃腺癌患者外周血中SDF-1α的升高或提示淋巴结、肝及肺转移可能,并预示胃腺癌患者预后较差。Objective To detect the content of stromal cell derived factor-lα（SDF-1α） in peripheral blood of patients with gastric adenocarcinoma（GC） and investigate its clinical significances.Methods The contents of SDF-1αin the peripheral blood of 90 patients with GC were detected by enzyme-linked immunosorbent assay.The correlation of SDF-1α content with the clinicopathologic parameters and prognosis after operation were analyzed.Results ① The content of SDF-1α in the patients with GC[（6 950.8±l 131.3） ng/L） was significantly higher than that in the normal healthy volunteers[（5 023.7±l 103.8） ng/L,P=0.036）.② The content of SDF-1α in the GC patients with distant metastasis[（8 251.6±1 042.5） ng/L） was significantly higher than that without distant metastasis[（6 785.3±1 025.0） ng/L,P〈0.001）.The contents of SDF-1α in the peripheral blood of patients with distant metastasis either in the liver（P=0.002） or in the lung（P=0.030） were significantly higher than those without distant metastasis（liver or lung）.③ The TNM stage was later（P〈0.001）,lymph node metastasis was broader（P=0.018）,invasion of tumor was deeper（P〈0.001）,vascular invasion（P〈0.001） and lymphatic vessel invasion were present（P〈0.001）,the contents of SDF-1α were higer.Logistic regression analysis revealed that the depth of tumor invasion（OR=14.999,95%CI 3.568- 74.456,P=0.027） and distant metastasis（OR=0.186,95%CI 0.610- 2.014,P=0.026） were correlated with the high SDF-1α content.④ The survival time of the patients with higher content of SDF-1α was significantly shorter than that of the lower content of SDF-1α（P〈0.001）.Cox proportial hazard regression model analysis demonstrated that TNM stage（RR=2A97,95%CI 1.987- 10.238,P=0.009）,vascular invasion（RR=7.501,95%CI 2.086- 16.942,P=0.002）,and high content of SDF-1α（RR=18.302,95%CI 6.895-30.538,P=0.001） in the peripheral blood were the independent risk factors for survival of the patients with GC.Conc

关 键 词：胃 新生物/癌 转移 基质细胞衍生因子-1Α 预后 

分 类 号：R735.2[医药卫生—肿瘤]