出 处:《疑难病杂志》2022年第8期834-839,共6页Chinese Journal of Difficult and Complicated Cases
基 金:江苏省卫生健康委员会科研项目(N2019011)。
摘 要:目的观察胃癌组织中凋亡蛋白酶活化因子(Apaf-1)、单纯LIM结构域1(LMO1)的表达及其与胃癌患者预后的关系。方法收集2017年2月-2019年2月徐州市肿瘤医院消化内科接受手术治疗且术后完成随访胃癌患者80例临床资料,根据患者不同预后分为存活组、病死组,比较2组血清胃癌三项[胃泌素-17(G-17)、胃蛋白酶原Ⅰ(PGⅠ)、PGⅡ]、肿瘤标志物水平[癌胚抗原(CEA)、癌抗原19-9(CA19-9)、CA724]及胃癌组织中Apaf-1、LMO1表达情况,并分析二者与胃癌标志物关系。采用Logistic回归分析影响胃癌患者预后的因素。结果80例胃癌患者随访期间因肿瘤病死22例(27.50%),存活58例(72.50%);病死组胃癌Ⅳ期比例、有淋巴结转移比例、低分化程度比例均高于存活组(χ^(2)/P=2.109/0.035、4.396/0.036、2.056/0.040);2组患者血清G-17、PGⅠ、PGⅡ比较,差异均无统计学意义(P>0.05);病死组血清CEA、CA19-9和CA724水平高于存活组(t/P=2.656/0.010、2.738/0.008、2.943/0.004)。80例胃癌患者中Apaf-1阳性表达50例(62.50%),阴性表达30例(37.50%),LMO1阳性表达53例(66.25%),阴性27例(33.75%);病死组Apaf-1阳性表达率低于存活组,LMO1阳性表达率高于存活组(χ^(2)/P=16.067/<0.001、15.459/<0.001)。Apaf-1、LMO1阳性表达与血清G-17、PGⅠ、PGⅡ均无相关性(P>0.05),Apaf-1阳性表达与CEA、CA19-9、CA724均呈负相关(P<0.05),LMO1阳性表达与CEA、CA19-9、CA724均呈正相关(P<0.01)。胃癌组织中Apaf-1阳性表达是胃癌患者临床预后的保护因素[OR(95%CI)=0.119(0.036~0.400)],LMO1阳性表达是胃癌患者临床预后的危险因素[OR(95%CI)=17.053(1.990~146.111)]。结论胃癌组织中Apaf-1阳性表达是胃癌不良预后的保护因素,而LMO1则是不良预后的危险因素,均参与胃癌患者不良预后发生。Objective To observe the expressions of caspase activating factor(Apaf-1)and simple LIM domain 1(LMO1)in gastric cancer tissues and their relationship with the prognosis of gastric cancer patients.Methods The clinical data of 80 patients with gastric cancer who received surgical treatment and completed postoperative follow-up in the Department of Gastroenterology,Xuzhou Cancer Hospital from February 2017 to February 2019 were collected.According to the different prognosis of the patients,they were divided into a survival group and a death group.The serum gastric cancer between the two groups was compared.[gastrin-17(G-17),pepsinogen I(PGⅠ),PGⅡ],tumor marker levels[carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9),CA724]and gastric cancer The expression of Apaf-1 and LMO1 in the tissue was analyzed,and the relationship between the two and gastric cancer markers was analyzed.Logistic regression was used to analyze the prognostic factors of gastric cancer patients.Results During the follow-up period of 80 gastric cancer patients,22(27.50%)died due to tumor,and 58(72.50%)survived;the proportion of gastric cancer stage IV,lymph node metastasis and poorly differentiated degree in the death group were higher than those in the survival group(χ^(2)/P=2.109/0.035,4.396/0.036,2.056/0.040);there was no significant difference in serum G-17,PGⅠ,PGⅡbetween the two groups(P>0.05);the serum levels of CEA,CA19-9 and CA724 in the death group were higher In the survival group(t/P=2.656/0.010,2.738/0.008,2.943/0.004);among the 80 gastric cancer patients,50(62.50%)were positive for Apaf-1,and 30(37.50%)were negative,and LMO1 was positive in 53 cases(66.25%)and 27 cases(33.75%)were negative;the positive expression rate of Apaf-1 in the death group was lower than that in the survival group,and the positive expression rate of LMO1 was higher than that in the survival group(χ^(2)/P=16.067/<0.001,15.459/<0.001);Apaf-1,LMO1 positive expression was not correlated with serum G-17,PGⅠ,PGⅡ(P>0.05),Apaf-1 positive expressio
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