术前血清E-selectin与ICAM-1及MMP-2表达与肺癌手术患者预后的关系  

Correlation Between Preoperative Expressions of Serum E-Selectin ICAM-1 and MMP-2 and Prognosis of Patients After Lung Cancer Surgery

作　　者：张家艳[1] 李燕舞[1] 范华颖[1] 杨春茂[1] 魏华华 ZHANG Jiayan;LI Yanwu;FAN Huaying(Chengdu Third People's Hospital, Sichuan Chengdu 610031, China)

机构地区：[1]四川省成都市第三人民医院呼吸与危重症医学科,四川成都610031

出　　处：《河北医学》2020年第11期1771-1776,共6页Hebei Medicine

基　　金：国家自然科学基金项目,(编号:81970026)。

摘　　要：目的:探讨术前血清E-选择素(E-selectin)、细胞间黏附分子-1(ICAM-1)、基质金属蛋白酶-2(MMP-2)表达与肺癌手术患者预后的相关性。方法:选取2015年1月至2016年12月我院收治的肺癌患者95例,选择同时期健康体检者80例为对照组。肺癌患者分别于术前、术后1周、术后1个月以及对照组于体检当天检测血清E-selectin、ICAM-1、MMP-2水平。随访3年以上,记录患者生存情况,用受试者工作曲线(ROC)和曲线下面积(AUC)分析术前血清E-selectin、ICAM-1、MMP-2对预后的预测价值。影响肺癌患者预后的多因素分析采用COX比例风险回归模型,以血清结果中位数为分界点,将患者分为低表达组(<中位值,47例)和高表达组(≥中位值,48例),记录生存时间,绘制Kaplan-Meier生存曲线。结果:肺癌组术前、术后1周、术后1个月血清E-selectin、ICAM-1、MMP-2水平呈下降趋势(P<0.05),但均高于对照组(P<0.05);死亡组术前血清E-selectin、ICAM-1、MMP-2水平均高于存活组(P<0.05);术前血清E-selectin、ICAM-1、MMP-2预测患者3年死亡的AUC值分别为0.869、0.830、0.808,低于联合检测的AUC值0.972(P<0.05);COX比例风险回归分析结果显示,术前血清E-selectin、ICAM-1、MMP-2均为影响肺癌手术患者预后的独立因素(P<0.05);术前血清E-selectin、ICAM-1、MMP-2低表达组3年生存率分别为21.28%、23.40%、23.40%,高于高表达组的10.42%、8.33%、8.33%(P<0.05)。结论:肺癌患者手术前后血清E-selectin、ICAM-1、MMP-2水平均高于健康人群,术前三项指标均为影响预后的独立因素,对患者3年生存情况有较高的预测价值,术前血清指标低表达者生存期更长,预后更好。Objective:To explore the correlation between preoperative expressions of serum E-selectin,intercellular adhesion molecule-1(ICAM-1)and matrix metalloproteinase-2(MMP-2)and prognosis of patients after lung cancer surgery.Methods:Ninety-five patients with lung cancer treated in our hospital from January 2015 to December 2016 were selected,and 80 healthy people for physical examination at the same period were selected as control group.The levels of serum E-selectin,ICAM-1 and MMP-2 were detected among patients with lung cancer before surgery,at 1 week after surgery and at 1 month after surgery and in control group on the day of physical examination.The patients were followed up for more than 3 years,and the survival status was recorded.Receiver operating characteristic curve(ROC)and area under the curve(AUC)were used to analyze the predictive value of preoperative serum E-selectin,ICAM-1 and MMP-2 on prognosis.Multivariate analysis affecting the prognosis of lung cancer patients was performed by COX proportional hazard regression model.Taking the median value of serum results as the cut-off point,the patients were divided into low expression group(loss than median value,47 cases)and high expression group(more than median value,48 cases),and the survival time was recorded,and Kaplan-Meier survival curve was plotted.Results:The levels of serum E-selectin,ICAM-1 and MMP-2 in lung cancer group before surgery,at 1 week after surgery and at 1 month after surgery showed a decreasing trend(P<0.05),and were higher than those in control group(P<0.05).The levels of preoperative serum E-selectin,ICAM-1 and MMP-2 in death group were higher than those in survival group(P<0.05).The AUC values of preoperative serum E-selectin,ICAM-1 and MMP-2 in predicting 3-year death were 0.869,0.830 and 0.808 respectively,and they were lower than that of combined detection of 0.972(P<0.05).COX proportional hazard regression analysis results showed that preoperative serum E-selectin,ICAM-1 and MMP-2 were independent factors for prognosis of patie

关 键 词：肺癌 E-选择素 内皮细胞间黏附分子-1 基质金属蛋白酶-2 

分 类 号：R73[医药卫生—肿瘤]