Fascin⁃1 mRNA联合肿瘤标志物对结直肠腺癌患者术后淋巴结转移和生存预后的评估价值  

Evaluation of Fascin⁃1 mRNA combined with tumor markers for postoperative lymph node metastasis and survival prognosis in patients with colorectal adenocarcinoma

作　　者：祁真玉 曹辉[2] 张志苏 王干勋 QI Zhenyu;CAO Hui;ZHANG Zhisu;WANG Jianxun(Department of Pathology,the General Hospital of Huainan Oriental Hospital Group,Huainan,Anhui,China,232001;Department of Gastrointestinal Surgery,the General Hospital of Huainan Oriental Hospital Group,Huainan,Anhui,China,232001;Department of Laboratory Medicine,the General Hospital of Huainan Oriental Hospital Group,Huainan,Anhui,China,232001)

机构地区：[1]淮南东方医院集团总院病理科,安徽淮南232001 [2]淮南东方医院集团总院胃肠外科,安徽淮南232001 [3]淮南东方医院集团总院检验科,安徽淮南232001

出　　处：《分子诊断与治疗杂志》2023年第7期1270-1274,共5页Journal of Molecular Diagnostics and Therapy

基　　金：马鞍山市科技计划项目(TL⁃2017⁃14)。

摘　　要：目的探讨Fascin⁃1 mRNA联合肿瘤标志物对结直肠腺癌患者术后淋巴结转移和生存预后的评估价值。方法选取2018年2月至2021年7月于淮南东方医院集团总院接受手术治疗患者97例作为研究对象,术后检测患者血清Fascin⁃1 mRNA、糖类抗原199(CA199)、肿瘤标志物癌胚抗原(CEA)水平,术后随访12个月。根据是否发生淋巴结转移分为淋巴结转移组(n=34)与无淋巴结转移组(n=63),比较两组血清Fascin⁃1 mRNA、CA199与CEA表达水平;根据随访12个月患者生存情况分为死亡组(n=37)与生存组(n=60),比较两组临床资料与Fascin⁃1 mRNA、CA199、CEA水平,进行单、多因素分析,绘制ROC曲线检验Fascin⁃1 mRNA、CA199、CEA对结直肠腺癌患者术后淋巴结转移与生存预后的诊断效能。结果淋巴结转移患者血清CA199、CEA与Fascin⁃1 mRNA表达水平均高于无淋巴结转移患者,差异具有统计学意义(t=4.299、4.271、4.492,P<0.05);死亡组与生存组患者肿瘤大小、TNM分期、术后是否接受化疗、有无淋巴结转移、CA19⁃9、CEA、Fascin⁃1 mRNA水平比较差异具有统计学意义(χ^(2)=5.167、5.167、2.428、9.488,t=4.360、4.497、6.993,P<0.05);多因素logistic回归分析结果显示淋巴结转移、CA19⁃9、CEA、Fascin⁃1 mRNA表达水平为结直肠腺癌患者术后12月生存预后独立影响因素(P<0.05);ROC曲线结果显示Fascin⁃1 mRNA联合CA199、CEA检测均对术后淋巴结转移和生存预后的AUC分别为0.940、0.989,敏感度分别为0.882、0.946,特异度分别为0.857、0.983。结论Fascin⁃1 mRNA、CA199、CEA对结直肠腺癌患者术后淋巴结转移和生存预后具有良好的预测价值,三项指标联合可提高预测价值。Objective To investigate the value of Fascin⁃1 mRNA combined with tumor markers for the evaluation of postoperative lymph node metastasis and survival prognosis of patients with colorectal ade⁃nocarcinoma.Methods A total of 97 patients who underwent surgical treatment at the General Hospital of Huainan Oriental Hospital Group between February 2018 and July 2021 were enrolled in the study,and serum levels of fascin⁃1 mRNA,carbohydrate antigen 199(CA199),and the tumor marker carcinoembryonic anti⁃gen(CEA)were measured in the patients after surgery and followed up for 12 months.Serum levels of fascin⁃1 mRNA,CA199 and CEA were compared between the two groups stratified according to whether lymph node me⁃tastasis developed(n=34)or not(n=63).Patients were divided into those who died(n=37)versus those who survived(n=60)according to the survival status at 12 months of follow⁃up,the clinical data of the two groups were compared with the levels of Fascin⁃1 mRNA,CA19⁃9,and CEA,univariate and multivariate analyses were performed,and the ROC curves were drawn to test the diagnostic efficacy of Fascin⁃1 mRNA,CA199,and CEA for the prognosis of postoperative lymph node metastasis and survival in patients with colorectal adeno⁃carcinoma.Results The expression levels of serum CA199,CEA and Fascin⁃1 mRNA in patients with lymph node metastasis were significantly higher than those in patients without lymph node metastasis(t=4.299,4.271,4.492,P<0.05).There were statistically significant differences in tumor size,TNM stage,postoperative chemo⁃therapy,lymph node metastasis,CA19⁃9,CEA,Fascin⁃1 mRNA levels between the death group and the surviv⁃al group(χ^(2)=5.167,5.167,2.428,9.488,t=4.360,4.497,6.993,P<0.05).Multivariate logistic regression anal⁃ysis identified lymph node metastasis,CA19⁃9,CEA,and Fascin⁃1 mRNA expression levels as independent prognostic factors for 12⁃month survival of colorectal adenocarcinoma patients(P<0.05).The results of ROC showed that the AUC of Fascin⁃1 mRNA combined w

关 键 词：Fascin⁃1 mRNA 瘤标志物 结直肠腺癌 淋巴结转移 生存预后 

分 类 号：R735.34[医药卫生—肿瘤]