血清CXC趋化因子受体5和血小板内皮细胞黏附分子-1对胃癌的诊断和预后评估价值  

Value of serum CXC chemokine receptor 5 and platelet endothelial cell adhesion molecule-1 in diagnosis and prognosis of gastric cancer

作　　者：杨浩 王军 严雪琴 张杰 顾永兴 张晓雨[3] YANG Hao;WANG Jun;YAN Xueqin;ZHANG Jie;GU Yongxing;ZHANG Xiaoyu(Department of Emergency Surgery,Huai′an People′s Hospital of Hongze District,Huai′an,Jiangsu 223100,China;Department of General Surgery,Huai′an People′s Hospital of Hongze District,Huai′an,Jiangsu 223100,China;Department of General Surgery,Huai′an Second People′s Hospital,Huai′an,Jiangsu 223002,China)

机构地区：[1]淮安市洪泽区人民医院急诊外科,江苏淮安223100 [2]淮安市洪泽区人民医院普外科,江苏淮安223100 [3]淮安市第二人民医院普外科,江苏淮安223002

出　　处：《国际检验医学杂志》2023年第5期576-581,587,共7页International Journal of Laboratory Medicine

基　　金：江苏省“六大人才高峰”高层次人才选拔培养资助项目(WSW-291)。

摘　　要：目的探讨血清CXC趋化因子受体5(CXCR5)和血小板内皮细胞黏附分子-1(PECAM-1)对胃癌的诊断和预后评估价值。方法选取2014年1月至2015年10月淮安市洪泽区人民医院收治的经病理确诊的102例胃癌患者为研究组,另选取同期性别和年龄相匹配的80例体检健康者为对照组。采用酶联免疫吸附试验法检测血清CXCR5和PECAM-1水平,采用受试者工作特征曲线(ROC曲线)分析CXCR5和PECAM-1对胃癌的诊断效能,以及与胃癌临床病理特征的关系。定期随访胃癌患者5年,比较存活组和死亡组血清CXCR5和PECAM-1水平,采用ROC曲线分析CXCR5和PECAM-1对胃癌死亡的预测效能,采用多因素Cox回归分析影响死亡的危险因素,比较CXCR5和PECAM-1高表达与低表达患者5年总生存率的差异。结果研究组血清CXCR5和PECAM-1水平明显高于对照组,差异有统计学意义(t=8.562、21.235,P<0.05)。ROC曲线结果显示,CXCR5、PECAM-1和两者联合诊断胃癌的曲线下面积(AUC)分别为0.829、0.874和0.912(P<0.05)。TNM分期为Ⅲ~Ⅳ期患者CXCR5和PECAM-1水平明显高于Ⅰ~Ⅱ期,低分化患者CXCR5和PECAM-1水平高于中高分化,淋巴结转移患者CXCR5和PECAM-1水平高于无淋巴结转移,肿瘤最大径>5 cm患者CXCR5和PECAM-1水平高于肿瘤最大径≤5 cm,差异均有统计学意义(P<0.05)。随访胃癌患者5年后,生存率为53.9%(55/102),死亡组血清CXCR5和PECAM-1水平明显高于存活组,差异有统计学意义(t=10.235、24.235,P<0.05)。ROC曲线结果显示,CXCR5、PECAM-1和两者联合诊断预测胃癌死亡的AUC分别为0.754、0.801和0.866(P<0.05)。Cox回归分析显示,TNM分期、淋巴结转移、肿瘤最大径、CXCR5和PECAM-1是影响胃癌预后的危险因素(P<0.05)。生存分析显示,CXCR5高表达患者5年总生存率比CXCR5低表达患者明显降低(χ^(2)=6.416,P=0.011);PECAM-1高表达患者5年总生存率比PECAM-1低表达患者明显降低(χ^(2)=16.052,P<0.001)。结论血清CXCR5和PECAM-1高表达�Objective To explore the value of CXC chemokine receptor 5(CXCR5)and platelet endothelial cell adhesion molecule-1(PECAM-1)in the diagnosis and prognosis of gastric cancer.Methods A total of 102 patients with gastric cancer who were pathologically confirmed in Huai′an People′s Hospital of Hongze District from January 2014 to October 2015 were selected as the study group,and 80 healthy people matched with gender and age were selected as the control group.The serum levels of CXCR5 and PECAM-1 were detected by enzyme-linked immunosorbent assay.The diagnostic efficacy of CXCR5 and PECAM-1 for gastric cancer was analyzed by receiver operating characteristic curve(ROC curve),and the relationship between CXCR5,PECAM-1 and clinicopathological characteristics of gastric cancer was analyzed.The serum levels of CXCR5 and PECAM-1 in survival and death patients were compared after 5-year follow-up,and the predictive effect of CXCR5 and PECAM-1 for gastric cancer death was analyzed by ROC curve.The risk factors of death were screened by multivariate Cox regression analysis,and the difference of 5-year overall survival between patients with high and low expression of CXCR5 and PECAM-1 was compared.Results The serum CXCR5 and PECAM-1 levels in the study group were significantly higher than those in the control group,with statistical significance(t=8.562,21.235,P<0.05).ROC curve results showed that the area under curve(AUC)of CXCR5,PECAM-1 and combined CXCR5 in the diagnosis of gastric cancer were 0.829,0.874 and 0.912,respectively(P<0.05).The levels of CXCR5 and PECAM-1 in patients with TNM stageⅢ-Ⅳwere significantly higher than those in patients with stageⅠ-Ⅱ,the levels of CXCR5 and PECAM-1 in patients with low differentiation were higher than those in patients with moderate and high differentiation,and the levels of CXCR5 and PECAM-1 in patients with lymph node metastasis were higher than those without lymph node metastasis.The CXCR5 and PECAM-1 levels in patients with maximum tumor diameter>5 cm were higher than t

关 键 词：CXC趋化因子受体5 血小板内皮细胞黏附分子-1 胃癌 预后 病理特征 

分 类 号：R735.2[医药卫生—肿瘤]