胃癌患者手术前后血清VEGF、MMP-2、MMP-9水平变化及其临床意义  

Changes and clinical significance of serum VEGF,MMP-2 and MMP-9 levels in patients with gastric cancer before and after surgery

作　　者：董磊[1] 夏猛[1] 尚康兴 吴情 DONG Lei;XIA Meng;SHANG Kangxing;WU Qing(General Hospital of Wanbei Coal Power Group,Suzhou,Anhui,China,234000)

机构地区：[1]皖北煤电集团总医院胃肠外科,安徽宿州234000

出　　处：《分子诊断与治疗杂志》2020年第9期1221-1225,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省卫生厅科研项目(2019LB0058)。

摘　　要：目的探讨胃癌患者手术前后血清血管内皮生长因子(VEGF)、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)水平变化及其临床意义。方法选取84例胃癌患者资料作为胃癌组,另择同期56例健康志愿者作为对照组,对比胃癌组术前和对照组的血清VEGF、MMP-2、MMP-9水平变化;对比胃癌组术前及术后7 d的血清VEGF、MMP-2、MMP-9水平变化。根据淋巴结转移情况将胃癌组分为胃癌组淋巴结转移组38例,胃癌淋巴结非转移组46例,对比转移组和非转移组的血清VEGF、MMP-2、MMP-9水平,分析单个指标及三者联合指标诊断胃癌患者淋巴结转移的灵敏度及特异性。结果胃癌组术前血清VEGF、MMP-2、MMP-9水平显著高于对照组,差异具有统计学意义(P<0.05);胃癌组术后7 d的血清VEGF、MMP-2、MMP-9水平显著低于术前,差异具有统计学意义(P<0.05);胃癌淋巴结转移组的血清VEGF、MMP-2、MMP-9水平显著高于非淋巴结转移组,差异具有统计学意义(P<0.05);对血清VEGF、MMP-2、MMP-9相对表达水平及三者联合检测做作ROC曲线分析,AUC分别为0.896、0.744、0.847及0.994时,95%CI分别为0.810~0.952、0.637~0.833、0.752~0.816及0.945~1.000,临界值分别取180.90、5.63、415.91及0.36时,诊断胃癌患者淋巴结转移的灵敏度分别为78.95%、63.16%、73.68%及97.37%,特异度分别为95.65%、91.30%、93.48%及97.83%,最大约登指数为0.76、0.54、0.67及0.95。结论术前血清VEGF、MMP-2、MMP-9水平可作为诊断胃癌患者淋巴结转移的肿瘤标志物,其中将三种血清因子联合检测用于胃癌患者淋巴结转移的诊断价值最高,临床动态检测上述血清因子水平可利于患者预后判断,为其术后治疗策略提供依据。Objective To explore the changes and clinical significance of serum vascular endothelial growth factor(VEGF),matrix metalloproteinase-2(MMP-2)and matrix metalloproteinase-9(MMP-9)levels in patients with gastric cancer before and after surgery. Methods A retrospective cohort study method was used in this study,and the data of 84 patients with gastric cancer(gastric cancer group)were retrospectively analyzed,and another 56 healthy volunteers(control group)were selected during the same period. The changes of serum VEGF,MMP-2 and MMP-9 levels were compared in gastric cancer group before surgery and at 7 d after surgery and in control group before surgery. There were 38 cases in gastric cancer lymph node metastasis group and 46 cases in lymph node non-metastasis group in gastric cancer group. The levels of serum VEGF,MMP-2 and MMP-9 were compared between metastasis group and non-metastasis group. The sensitivity and specificity of single indicator and combination of the three in the diagnosis of lymph node metastasis in patients with gastric cancer were analyzed. Results The levels of serum VEGF,MMP-2 and MMP-9 in gastric cancer group before surgery were significantly higher than those in control group(P<0.05).The levels of serum VEGF,MMP-2 and MMP-9 in gastric cancer group at 7 d after surgery were significantly lower than those before surgery(P<0.05). The levels of serum VEGF,MMP-2 and MMP-9 in gastric cancer lymph node metastasis group were significantly higher than those in lymph node non-metastasis group(P<0.05). ROC curve analysis of relative expression level of serum VEGF or MMP-2 or MMP-9 and combination of the three showed when AUC values were 0.896,0.744,0.847 and 0.994,the 95% CI values were 0.810 to0.952,0.637 to 0.833,0.752 to 0.816 and 0.945 to 1.000. When the critical values were 180.90,5.63,415.91 and 0.36,the sensitivities in the diagnosis of lymph node metastases in patients with gastric cancer were78.95%,63.16%,73.68% and 97.37%,and the specificities were 95.65%,91.30%,93.48% and 97.83%respectively,

关 键 词：胃癌 淋巴结转移 血管内皮生长因子(VEGF) 基质金属蛋白酶-2(MMP-2) 基质金属蛋白酶-9(MMP-9) 

分 类 号：R735.2[医药卫生—肿瘤]