腹腔镜结直肠癌根治术前病人外周血穿透素-联合miR-486-3p水平预测术后复发转移的价值探讨  

The value of peripheral blood PTX-3 combined with miR-486-3p in predicting postoperative recurrence and metastasis before laparoscopic radical resection of colorectal cancer

作　　者：孙会群 马熙 高星 SUN Huiqun;MA Xi;GAO Xing(Anorectal surgery,Tianjin Hospital,Tianjin 300000,China)

机构地区：[1]天津医院肛肠外科,300000

出　　处：《临床外科杂志》2023年第10期954-958,共5页Journal of Clinical Surgery

摘　　要：目的探讨腹腔镜结直肠癌根治术前病人外周血穿透素-3(PTX-3)联合miR-486-3p预测术后复发转移的价值。方法2018年3月~2021年5月我院收治的腹腔镜结直肠癌根治术病人157例,术前检测所有病人外周血PTX-3、miR-486-3p水平,术后随访1年,根据病人术后是否发生复发转移分为复发转移组与非复发转移组。比较两组病人临床资料,采用多因素Logistic回归分析腹腔镜结直肠癌根治术后复发转移的相关因素,绘制受试者工作特征曲线(ROC),以曲线下面积(AUC)评估预测价值。结果随访1年,157例病人失访5例,随访率为96.82%,其中复发转移28例,复发转移率为18.42%,124例未复发转移。复发转移组年龄≥60岁、淋巴结转移、Ⅲ期、低分化、肿瘤直径≥5 cm、术前血小板计数、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、外周血PTX-3、miR-486-3p水平高于非复发转移组(P<0.05)。Logistic回归分析结果显示,淋巴结转移、Ⅲ期、低分化、术前外周血PTX-3水平、术前外周血miR-486-3p水平为腹腔镜结直肠癌根治术后复发转移的影响因素(P<0.05)。ROC曲线结果显示,外周血PTX-3、miR-486-3p水平及二者联合预测腹腔镜结直肠癌根治术后复发转移的AUC值(95%CI)分别为0.746(0.643~0.833)、0.805(0.707~0.881)、0.868(0.779~0.930)(P<0.05),二者联合的AUC值均高于单独检测的AUC值(P<0.05)。术前外周血PTX-3联合外周血miR-486-3p水平预测腹腔镜结直肠癌根治术后复发转移的AUC值高于淋巴结转移、Ⅲ期联合低分化预测的AUC值(P<0.05)。结论术前检测外周血PTX-3、miR-486-3p水平可用于预测腹腔镜结直肠癌根治术后复发转移,二者联合具有更高的预测价值。Objective To investigate the value of peripheral blood penetrating cytokine 3(PTX-3)combined with miR-486-3p in predicting postoperative recurrence and metastasis before laparoscopic radical resection of colorectal cancer.Methods A total of 157 patients with laparoscopic radical resection of colorectal cancer were selected from March 2018 to May 2021.The levels of PTX-3 and miR-486-3p in peripheral blood of all patients were detected before surgery,and patients were followed up for 1 year after surgery.Patients were divided into relapse-metastasis group and non-relapse-metastasis group according to the recurrence and metastasis after surgery.The clinical data of the two groups were compared,and the factors related to recurrence and metastasis after laparoscopic radical resection of colorectal cancer were analyzed by multivariate Logistic regression.The receiver operating characteristic curve(ROC)was plotted,and the area under the curve(AUC)was used to evaluate the predictive value.Results After 1 year’s follow-up,5 of 157 patients were lost to follow-up,with a follow-up rate of 96.82%.Among them,recurrence and metastasis was 28 patients,recurrence and metastasis rate was 18.42%,and the remaining 124 patients had no recurrence and metastasis.Age≥60 years old,lymph node metastasis,stage Ⅲ,low differentiation,tumor diameter≥5cm,preoperative platelet count,CEA,glycoantigen 19-9(CA19-9),peripheral blood PTX-3,miR-486-3p levels in the relapsed and metastatic group were higher than those in the non-relapsed and metastatic group(P<0.05).Logistic regression analysis showed that lymph node metastasis,stage Ⅲ,low differentiation,preoperative peripheral blood PTX-3 level and preoperative peripheral blood miR-486-3p level were the factors affecting recurrence and metastasis after laparoscopic radical resection of colorectal cancer(P<0.05).ROC curve results show that,The AUC values(95%CI)of peripheral blood PTX-3,miR-486-3p and their combination in predicting recurrence and metastasis after laparoscopic radical resec

关 键 词：腹腔镜结直肠癌根治术 穿透素-3 miR-486-3p 复发转移 预测价值 

分 类 号：R735.34[医药卫生—肿瘤]