胃癌根治术前后血清IGF-Ⅰ、AFP、Gli1和CD147水平变化以及预后评估价值  

Changes of Levels of Serum IGF-Ⅰ, AFP, Gli1 and CD147 Before and After Radical Resection of Gastric Cancer and Their Value on Prognosis Evaluation

作　　者：施雪松[1] 肖华[1] 曹红勇[1] SHI Xue-song;XIAO Hua;CAO Hong-yong(Department of General Surgery,Nanjing Hospital of Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院普外科,南京210006

出　　处：《临床误诊误治》2020年第6期86-91,共6页Clinical Misdiagnosis & Mistherapy

基　　金：江苏省基础研究计划(自然科学基金)面上项目(BK20191118)。

摘　　要：目的观察胃癌根治术前后血清胰岛素样生长因子-Ⅰ(insulin-like growth factor-Ⅰ,IGF-Ⅰ)、甲胎蛋白(alpha fetal protein,AFP)、胶质瘤相关癌基因1(glioma-associated oncogene 1,Gli1)和CD147水平变化以及对预后的评估价值。方法选取2014年2月—2016年2月收治的拟行根治术治疗的142例胃癌作为观察组,选取同期行健康体检的健康者80例作为对照组。观察组常规实施胃癌根治术治疗,术后给予卡培他滨维持化疗,根据术后有无病情复发或远处转移分为预后不良组和预后良好组。记录观察组术前、术后7 d及对照组健康体检时血清IGF-Ⅰ、AFP、Gli1及CD147的水平变化,分析血清IGF-Ⅰ、AFP、Gli1及CD147对胃癌根治术患者预后的评估价值。结果与对照组比较,观察组术前血清IGF-Ⅰ、AFP、Gli1、CD147及术后7 d血清IGF-Ⅰ、Gli1、CD147水平升高,差异有统计学意义(P<0.01);观察组术后7 d血清IGF-Ⅰ、AFP、Gli1、CD147水平较术前下降,差异有统计学意义(P<0.01)。与预后不良组比较,预后良好组术后7 d血清IGF-Ⅰ、Gli1、CD147水平下降,差异有统计学意义(P<0.01);与本组术前比较,预后良好组、预后不良组术后7 d血清IGF-Ⅰ、AFP、Gli1、CD147水平降低,差异有统计学意义(P<0.01)。Cox回归分析显示,血清IGF-Ⅰ、Gli1及CD147是影响胃癌根治术患者预后不良的重要因素(P<0.05或P<0.01)。受试者工作特征曲线分析显示,血清Gli1及CD147对胃癌根治术患者预后的诊断价值较高,并且联合检测可进一步提升判断价值。结论胃癌根治术后患者血清IGF-Ⅰ、AFP、Gli1及CD147水平明显降低,且IGF-Ⅰ、Gli1和CD147是影响胃癌根治术后病情复发和远处转移的重要因素,联合各项指标检测对预测胃癌根治术后病情复发和远处转移具有重要参考价值。Objective To observe the changes of levels of serum insulin-like growth factor-Ⅰ(IGF-Ⅰ), alpha-fetoprotein(AFP), glioma-associated oncogene 1(Gli1) and CD147 before and after radical resection of gastric cancer and the value in prognosis evaluation. Methods From February 2014 to February 2016, 142 patients with gastric cancer who were scheduled to undergo radical resection were selected as observation group, and 80 healthy subjects undergoing physical examination during the same period were selected as control group. Observation group was routinely treated with radical resection of gastric cancer, and given Capecitabine for maintenance chemotherapy after surgery. The patients were divided into poor prognosis group and good prognosis group according to the presence or absence of recurrence or distant metastasis after surgery. Serum levels of IGF-Ⅰ, AFP, Gli1 and CD147 were recorded in observation group before surgery and at 7 d after surgery and in control group at physical examination. The value of serum IGF-Ⅰ, AFP, Gli1 and CD147 in prognosis evaluation in patients with radical resection of gastric cancer was analyzed. Results The levels of serum IGF-Ⅰ, AFP, Gli1 and CD147 in observation group before surgery and levels of serum IGF-Ⅰ, Gli1 and CD147 at 7 d after surgery were increased compared with those in control group(P<0.01). The levels of serum IGF-Ⅰ, AFP, Gli1 and CD147 in observation group at 7 d after surgery were decreased compared with those before surgery(P<0.01). The levels of serum IGF-Ⅰ, Gli1 and CD147 in good prognosis group at 7 d after surgery were decreased compared with those in poor prognosis group(P<0.01). The levels of serum IGF-Ⅰ, AFP, Gli1 and CD147 in good prognosis group and poor prognosis group at 7 d after surgery were decreased compared with those in the same group before surgery(P<0.01). Cox regression analysis showed that serum IGF-Ⅰ, Gli1 and CD147 were important factors affecting the poor prognosis of patients with radical resection of gastric cancer(P<0.05 or

关 键 词：胃肿瘤 消化系统外科手术 复发 肿瘤转移 胰岛素样生长因子-Ⅰ 甲胎蛋白 胶质瘤相关癌基因1 

分 类 号：R735.2[医药卫生—肿瘤]