硫氧还蛋白还原酶活性检测在食管癌60例临床诊断中的应用  

Application of TR activity detection in clinical diagnosis of 60 cases of esophageal cancer

作　　者：仲思恂 郑良凤 鲁小敏 ZHONG Sixun;ZHENG Liangfeng;LU Xiaomin(Department of Oncology,Hai'an People's Hospital,Nantong,Jiangsu 226600,China)

机构地区：[1]海安市人民医院肿瘤科,江苏南通226600

出　　处：《安徽医药》2024年第3期560-564,I0006,共6页Anhui Medical and Pharmaceutical Journal

基　　金：南通市卫健委科研项目(QB2019012)。

摘　　要：目的 探究硫氧还蛋白还原酶(TR)活性检测在食管癌临床诊断中的应用。方法 2019年1月至2020年7月海安市人民医院收治的食管癌病人、食管良性病灶病人及同期于该院进行体检的健康者,即分为食管癌组、良性组和对照组,各60例。分别检测食管癌组、良性组和对照组病人血浆中TR活性;检测食管癌组织病人化疗前、化疗时和化疗后血浆中TR活性;比较食管癌组病人TR活性在不同分期、转移方面的差异;评估食管癌组病人手术预后,随访2年评估远期预后情况;确定TR活性检测对食管癌病人的诊断价值。结果 与对照组(3.16±0.79)U/mL相比,良性组(6.34±0.96)U/mL和食管癌组(8.12±1.25)U/mL病人血浆中TR活性均明显升高(P<0.05);且食管癌病人血浆中TR活性明显高于良性组(P<0.05)。与化疗前(8.12±1.25)U/mL相比,化疗时(4.65±0.87)U/mL和化疗后(3.37±0.62)U/mL食管癌病人血浆中TR活性均明显降低(P<0.05);且化疗后食管癌组病人血浆中TR活性明显低于化疗时(P<0.05)。TR活性表达和食管癌病人性别、年龄、肿瘤长径和肿瘤位置均无相关性(P>0.05),与病人淋巴结转移和TNM分期密切相关(P<0.05)。和Ⅰ&Ⅱ期食管癌病人相比,Ⅲ&Ⅳ期食管癌病人血浆中TR活性明显升高(P<0.05);和未转移食管癌病人相比,食管癌转移病人血浆中TR活性明显升高(P<0.05)。食管癌病人化疗后有39例病人得到了完全或部分缓解,病人总有效率为65%。对食管癌病人随访2年统计显示,食管癌病人2年生存率为75.0%(45例),TR高表达(>4 U/mL)2年生存人数为31(31/41)例,生存率为75.6%;TR低表达(<4 U/mL)2年生存率为14(14/19)例,生存率为73.7%;log-rank检验TR高表达和低表达病人生存率比较差异有统计学意义(P<0.05)。受试者操作特征曲线(ROC曲线)分析TR检测曲线下面积(AUC)值为0.92,特异度为83.2%,灵敏度为93.6%。结论 TR高表达于食管癌病人血浆中,其可用于食管癌的早期检测Objective To explore the application of thioredoxin reductase(TR) activity detection in the clinical diagnosis of esophageal cancer.Methods Patients with esophageal cancer and patients with benign esophageal lesions admitted to Hai'an People's Hospital from January 2019 to July 2020 and healthy subjects who underwent physical examination at the hospital during the same period were assigned into the esophageal cancer group,the benign group and the control group,with 60 cases in each.The TR activity in the plasma of patients with esophageal cancer group,benign group and control group was detected respectively;the TR activity in the plasma of patients with esophageal cancer tissue before chemotherapy,during chemotherapy and after chemotherapy was detected.The differences in TR activity among patients with esophageal cancer in different stages and metastases were compare;the surgical prognosis of patients in the esophageal cancer group was evaluated,and the long-term prognosis with a 2-year follow-up was evaluated;the diagnostic value of TR activity detection for esophageal cancer patients was determined.Results Compared with the control group(3.16±0.79) U/mL,the TR activity in the plasma of patients in the benign group(6.34±0.96) U/mL and the esophageal cancer group(8.12±1.25) U/mL was significantly increased(P<0.05);and the TR activity in the plasma of esophageal cancer patients was significantly higher than that of the benign group(P<0.05).Compared with before chemotherapy(8.12±1.25) U/mL,TR activity in the plasma of esophageal cancer patients during chemotherapy(4.65±0.87) U/mL and after chemotherapy(3.37±0.62) U/mL was significantly reduced(P<0.05);and the TR activity in the plasma of patients with esophageal cancer after chemotherapy was significantly lower than that during chemotherapy(P<0.05).There was no correlation between TR activity expression and gender,age,tumor diameter and tumor location in patients with esophageal cancer(P>0.05),which was closely associated with lymph node metastasis and TNM st

关 键 词：硫氧还蛋白还原酶 食管肿瘤 预后 肿瘤标志物 生存率 

分 类 号：R735.1[医药卫生—肿瘤]