术前AGR、NLR、FOXQ1联合检测对低位直肠癌根治性切除手术患者术后复发的预测价值  

Prognostic Value of Preoperative AGR,NLR and FOXQ1 Combined Detection for Postoperative Recurrence of Patients Undergoing Radical Resection of Low Rectal Cancer

作　　者：黄臻[1] 李铁军[1] 高源泽 潘永鹏 王迎岗 HUANG Zhen;LI Tie-jun;GAO Yuan-ze;PAN Yong-peng;WANG Ying-gang(Second Department of General Surgery,Chongqing Ninth People's Hospital,Chongqing,400700,China)

机构地区：[1]重庆市第九人民医院普外二科,重庆400700

出　　处：《现代生物医学进展》2022年第9期1754-1759,共6页Progress in Modern Biomedicine

基　　金：重庆市卫生局医学科研项目(2012-2-291)。

摘　　要：目的:探讨术前白蛋白-球蛋白比值(AGR)、中性粒细胞-淋巴细胞比值(NLR)、叉头框蛋白Q1(FOXQ1)联合检测对低位直肠癌根治性切除手术患者术后复发的预测价值。方法:选取2017年3月至2019年4月重庆市第九人民医院就诊的拟行低位直肠癌根治性切除手术患者110例,术前均检测血清AGR、NLR、FOXQ1水平。随访3~48个月,中位随访时间为25.5个月,失访9例,101例根据术后复发情况将患者分为复发组(n=16)和未复发组(n=85)。比较两组患者术前血清AGR、NLR、FOXQ1水平,收集患者的临床资料,以Logistic回归分析探讨低位直肠癌患者术后复发的危险因素,绘制受试者工作曲线(ROC)判定术前血清AGR、NLR、FOXQ1水平对低位直肠癌患者术后复发的预测价值。结果:复发组术前血清AGR水平低于未复发组,术前血清NLR、FOXQ1水平高于未复发组(P<0.05);复发组患者肿瘤细胞分化程度为低分化、TNM分期为Ⅲ期、糖链抗原19-9(CA19-9)阳性占比高于未复发组(P<0.05),复发组术后化疗占比低于未复发组(P<0.05);Logistic回归分析结果显示,TNM分期为Ⅲ期、细胞分化程度为低分化、术前血清AGR降低、NLR升高、FOXQ1升高均为低位直肠癌患者术后复发的危险因素(P<0.05);ROC曲线结果显示,术前血清AGR、NLR、FOXQ1水平及三者联合对低位直肠癌患者术后复发的预测的曲线下面积(AUC)值分别为0.738、0.747、0.731、0.842。结论:术前检测血清AGR、NLR、FOXQ1水平对低位直肠癌根治性切除术患者术后复发预测具有一定的价值,且联合的预测价值更高。Objective:To investigate the prognostic value of preoperative albumin-globulin ratio(AGR),neutrophil-lymphocyte ratio(NLR) and forkhead box protein Q1(FOXQ1) combined detection for postoperative recurrence of patients undergoing radical resection of low rectal cancer.Methods:A total of 110 patients who had undergoing radical resection of low rectal cancer who were admitted to the Ninth People’s Hospital of Chongqing from March 2017 to April 2019 were selected.Serum levels of AGR,NLR,and FOXQ1were detected before surgery.Follow-up was 3 to 48 months,the median follow-up time was 25.5 months,9 cases were lost to follow-up,101 cases were divided into recurrence group(n=16) and non recurrence group(n=85) according to the postoperative recurrence.The preoperative serum AGR,NLR,FOXQ1 levels of the two groups of patients were compared.The clinical data of patients were collected.Logistic regression analysis was used to explore the risk factors of postoperative recurrence in patients with low rectal cancer.The receiver operating curve(ROC) was drawn,and determine the predictive value of preoperative serum AGR,NLR,and FOXQ1 levels for postoperative recurrence in patients with low rectal cancer.Results:The preoperative serum AGR level of the recurrence group was lower than that of the non recurrence group,and the preoperative serum NLR and FOXQ1 levels were higher than those of the non recurrence group(P<0.05).The proportion of tumor cells differentiation degree low/undifferentiated,TNM staging was Ⅲ,and sugar carbohydrate antigen19-9(CA19-9) positive of the recurrence group were higher than those of the non recurrence group(P<0.05).The proportion of postoperative chemotherapy of the recurrence group was lower than that of the non recurrence group(P<0.05).Logistic regression analysis showed that TNM staging was Ⅲ,cell differentiation degree was low and preoperative serum AGR decreased,NLR increased,FOXQ1 increased were all risk factors for postoperative recurrence in patients with low rectal cancer(P<0.05).ROC curve

关 键 词：低位直肠癌根治性切除手术 白蛋白-球蛋白比值 中性粒细胞与淋巴细胞比值 叉头框蛋白Q1 术后复发 

分 类 号：R735.37[医药卫生—肿瘤]