Elafin 表达水平与食管癌切除术患者预后的相关性  

Correlation between Elafin expression level and prognosis of patients undergoing resection for esophageal cancer

作　　者：许家伦[1] 朱启淦 黄江宾 耿月华[1] 禹乐[1] XU Jiaun;ZHU Qigan;HUANG Jiangbin;GENG Yuehua;YU Le(Department of Pathology,the 909th Hospital,Dongnan Hospital of Xiamen University,Zhangzhou 363000,China)

机构地区：[1]第九○九医院,厦门大学附属东南医院病理科,福建漳州363000

出　　处：《胃肠病学和肝病学杂志》2024年第7期823-828,共6页Chinese Journal of Gastroenterology and Hepatology

基　　金：联勤保障部队第九〇九医院青年苗圃基金资助项目(20YQ005)。

摘　　要：目的分析Elafin表达水平与食管癌切除术患者预后的相关性。方法选取2020年1月至2022年1月就诊于我院外科的食管癌患者200例。监测患者人白细胞弹性蛋白酶特异性抑制剂(Elastase specific inhibitors,Elafin)表达水平,并行食管癌切除术。随访1年后根据预后情况分为不良预后组和对照组。比较两组患者临床资料、Elafin表达水平等情况。应用多因素Logistic回归分析Elafin表达水平等因素与食管癌切除术患者预后的相关性。应用ROC曲线分析相关因素预测食管癌切除术患者预后的价值。结果纳入研究的200例患者中有12例病例脱落。剩余188例患者中有41例纳入不良预后组,147例纳入对照组,预后不良发生率为21.81%(41/188)。两组患者年龄、葡萄糖等临床资料对比,差异无统计学意义(P>0.05)。但不良预后组临床分期Ⅲ期、低分化和有淋巴结转移所占的比例均大于对照组(P<0.05),不良预后组Elafin水平低于对照组(P<0.05)。多因素Logistic回归分析显示,临床分期(OR=5.898)、分化程度(OR=3.012)和淋巴结转移(OR=4.876)是影响食管癌切除术患者预后的独立危险因素,Elafin水平(OR=0.117)是影响食管癌切除术患者预后的保护性因素。ROC曲线显示,Elafin水平预测食管癌切除术后预后的诊断效能高于临床分期、分化程度和淋巴结转移,其中Elafin水平的最佳截点为0.49 ng/mL,此时敏感性为92.0%,特异性为80.9%。列线图预测食管癌切除术患者预后不良的一致性指数(C-index)为0.927(95%CI:0.873~0.951)。结论临床分期越高、分化程度越低和有淋巴结转移是影响食管癌切除术患者预后的危险因素,而Elafin表达水平则是保护性因素,早期监测有助于调整治疗方案、改善预后。Objective To analyze the correlation between Elafin expression level and prognosis of patients with esophageal cancer resection.Methods A total of 200 patients with esophageal cancer admitted to the Department of Surgery of our hospital from Jan.2020 to Jan.2022 were selected.The expression levels of Elafin in human leuko-cytes were monitored in all patients and concurrent resection of esophageal cancer was performed.After 1 year follow-up,they were divided into poor prognosis group and control group.Clinical data and Elafin expression levels were compared between the two groups.Multivariate Logistic regression was used to analyze the correlation between Elafin expression level and prognosis of patients with esophageal cancer resection.Results Of the 200 patients included in the study,12 cases fell out.Among the remained 188 patients,41 patients were included in poor prognosis group,and 147 cases were included in the control group.The incidence of poor prognosis was 21.81%(41/188).There was no significant difference in age,glucose and other clinical data between the two groups(P>0.05).However,the proportion of clinical stageⅢ,the proportion of low differentiation and the proportion of lymph node metastasis in the poor prognosis group were higher than those in the control group(P<0.05),and the level of Elafin in the poor prog-nosis group was lower than that in the control group(P<0.05).Multivariate Logistic regression analysis showed that clinical stage(OR=5.898),differentiation degree(OR=3.012)and lymph node metastasis(OR=4.876)were in-dependent risk factors for the prognosis of patients with esophagectomy.Elafin level(OR=0.117)was a protective factor for the prognosis of patients with esophagectomy.ROC curve showed that Elafin level was more effective in pre-dicting the prognosis of esophageal cancer after resection than clinical stage,differentiation degree and lymph node me-tastasis.The optimal cut-off point of Elafin level was 0.49 ng/mL,and the sensitivity and specificity were 92.0%and 80.9%.The consistenc

关 键 词：Elafin表达水平 食管癌切除术 多因素LOGISTIC回归分析 预后 

分 类 号：R735.1[医药卫生—肿瘤]