直肠癌患者根治术后盆腔引流液MMP-2、MMP-9、CRP、IL-1β、TNF-α预测早期吻合口瘘的临床价值  

The clinical value of MMP-2,MMP-9,CRP,IL-1βand TNF-αin pelvic drainage fluid after radical resection of rectal cancer in predicting early anastomotic fistula

作　　者：孟闯 张跃[2] 姚泽明[2] 王建[1] MENG Chuang;ZHANG Yue;YAO Zeming;WANG Jian(the First Clinical Institute,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Department of Gastrointestinal Surgery,Xuzhou Cancer Hospital,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州医科大学第一临床学院,江苏徐州221004 [2]徐州市肿瘤医院胃肠外科,江苏徐州221000

出　　处：《国际检验医学杂志》2021年第22期2772-2775,共4页International Journal of Laboratory Medicine

摘　　要：目的探讨直肠癌患者根治术后盆腔引流液基质金属蛋白酶(MMP)-2、MMP-9、C反应蛋白(CRP)、白细胞介素(IL)-1β、肿瘤坏死因子(TNF)-α预测早期吻合口瘘的临床价值。方法选取2017年1月至2020年11月于徐州市肿瘤医院接受直肠癌根治术的患者118例作为研究对象,根据患者术后是否出现吻合口瘘进行将其分为吻合口瘘组(32例)和对照组(86例)。比较两组患者一般资料以及手术相关指标;比较两组患者术后1、3、5 d盆腔引流液MMP-2、MMP-9、CRP、IL-1β、TNF-α水平,并绘制受试者工作特征(ROC)曲线分析MMP-2、MMP-9、CRP、IL-1β、TNF-α预测早期吻合口瘘的效能。结果术后3、5 d,对照组盆腔引流液MMP-2、MMP-9、CRP、IL-1β、TNF-α水平逐渐降低,吻合口瘘组盆腔引流液MMP-2、MMP-9水平逐渐降低,CRP、IL-1β、TNF-α水平逐渐升高,且吻合口瘘组患者盆腔引流液MMP-2、MMP-9水平显著低于对照组,CRP、IL-1β、TNF-α水平显著高于对照组(P<0.05),ROC曲线分析显示,盆腔引流液MMP-2、MMP-9、CRP、IL-1β、TNF-α联合检测对直肠癌根治术后早期吻合口瘘预测的灵敏度、特异度以及曲线下面积均优于各项单独检测。结论对于接受直肠癌根治术的患者,术后联合检测盆腔引流液MMP-2、MMP-9、CRP、IL-1β、TNF-α能够有效预测早期吻合口瘘。Objective To investigate the clinical value of the matrix metalloproteinases(MMP)-2,MMP-9,C-reactive protein(CRP),interleukin(IL)-1βand tumor necrosis factor(TNF)-αin pelvic drainage fluid for early anastomotic fistula in patients with rectal cancer.Methods A total of 118 patients underwent radical resection of rectal cancer in Xuzhou Cancer Hospital from January 2017 to November 2020 were selected and divided into anastomotic fistula group(32 cases)and the control group(86 cases)according to whether the patients had an anastomotic fistula after the operation.The general information and the surgical indicators;the levels of MMP-2,MMP-9,CRP,IL-1βand TNF-αin the pelvic drainage fluid on the 1,3,and 5 days after surgery were compared between the two groups.The clinical value of MMP-2,MMP-9,CRP,IL-1β,TNF-αin predicting early anastomotic leakage was analyzed using the receiver operating characteristic(ROC)curve drawn.Results After 3 and 5 days,in the pelvic drainage fluid,the levels of MMP-2,MMP-9,CRP,IL-1β,TNF-αgradually decreased in the control group,in the anastomotic fistula group,the levels of MMP-2,MMP-9 in pelvic drainage fluid gradually decreased,while the levels of CRP,IL-1βand TNF-αgradually increased.The levels of MMP-2,MMP-9 in pelvic drainage fluid in anastomotic fistula group were significantly lower than those in control group,and the levels of CRP,IL-1βand TNF-αwere significantly higher than those in control group(P<0.05).ROC curve analysis showed that the sensitivity,the specificity and the area under the curve of combined detection of MMP-2,MMP-9,CRP,IL-1βand TNF-αin pelvic drainage fluid were better than those of single detection for early anastomotic fistula prediction after radical resection of rectal cancer.Conclusion For patients undergoing radical rectal cancer surgery,combined detection of MMP-2,MMP-9,CRP,IL-1βand TNF-αin pelvic drainage fluid can effectively predict early anastomotic fistula.

关 键 词：直肠癌根治术 盆腔引流液 基质金属蛋白酶 C反应蛋白 白细胞介素-1Β 肿瘤坏死因子-α 

分 类 号：R735.3[医药卫生—肿瘤]