结直肠息肉组织中成纤维细胞生长因子19和胰岛素样生长因子1的表达与结直肠腺瘤性息肉发生的关系  

The relationship between the expression of fibroblast growth factor 19 and insulin-like growth factor 1 in colorectal polyp tissues and the occurrence of colorectal adenomas

作　　者：王昊 王海鹏 姚瑶 王东洋 陈明 孙燕来 张昊 董广峰 李增军 Wang Hao;Wang Haipeng;Yao Yao;Wang Dongyang;Chen Ming;Sun Yanlai;Zhang Hao;Dong Guangfeng;Li Zengjun(Second Ward,Department of Colorectal Surgery,Shandong Cancer Hospital and Institute Affiliated to Shandong First Medical University and Shandong Academy of Medical Science,Jinan 250117,China;Department of Endoscopy,Shandong Cancer Hospital and Institute Affiliated to Shandong First Medical University and Shandong Academy of Medical Science,Jinan 250117,China)

机构地区：[1]山东第一医科大学(山东省医学科学院)附属山东肿瘤医院及研究院结直肠外科二病区,济南250117 [2]山东第一医科大学(山东省医学科学院)附属山东肿瘤医院及研究院内镜科,济南250117

出　　处：《中华肿瘤杂志》2024年第8期776-781,共6页Chinese Journal of Oncology

基　　金：山东省自然科学基金(ZR2020LZL003);山东省自然科学基金面上项目(ZR2020MH254);济南市临床医学科技创新计划项目(202134062)。

摘　　要：目的探讨结直肠腺瘤性息肉与糖尿病及糖代谢相关分子的关系。方法收集2019年6月到2021年9月山东省肿瘤医院内镜科进行内镜下息肉切除术的40例患者,其中炎症性息肉27例,腺瘤性息肉13例。测量这些患者的空腹胰岛素、空腹血糖以及息肉组织中成纤维细胞生长因子19(FGF-19)和胰岛素样生长因子1(IGF-1)mRNA的表达。采用单因素和多因素logistic回归分析明确腺瘤性息肉发生的影响因素,基于多因素logistic回归分析结果构建预测腺瘤性息肉发生的列线图模型,并对模型进行区分度、校准度和临床适用性评价。结果腺瘤性息肉组患者的血糖、胰岛素、FGF-19和IGF-1的相对表达量分别为(8.67±2.70)mmol/L、(12.72±7.69)μU/L、2.20±1.88和1.36±0.69,均高于炎症性息肉组[分别为(5.51±0.72)mmol/L、(5.49±2.68)μU/L、0.53±0.97和0.41±0.46,均P=0.001]。多因素logistic回归分析显示,IGF-1的相对表达量为结直肠腺瘤性息肉发生的独立危险因素(OR=5.622,95%CI:1.085~29.126)。根据多因素logistic回归分析结果成功构建腺瘤性息肉的预测列线图模型。列线图模型的C指数为0.849,表明列线图模型的区分度较好。校准曲线显示,列线图模型的预测概率与实际观测结果的一致性尚可。临床决策曲线显示,列线图模型有一定的临床适用性。结论结直肠腺瘤性息肉的发生与糖代谢有关,糖尿病患者容易发生结直肠腺瘤。Objective This investigation sought to delineate the associations among colorectal adenomatous polyps,diabetes,and biomolecules involved in glucose metabolism.Method Data were collected from 40 patients who underwent endoscopic polypectomy at the Endoscopy Department of Shandong Cancer Hospital between June 2019 and September 2021.This cohort included 27 patients with inflammatory polyps and 13 with adenomatous polyps.We assessed fasting insulin(Fins),fasting blood glucose(FBG),and the mRNA expressions of fibroblast growth factor 19(FGF-19)and insulin-like growth factor 1(IGF-1)in the polyp tissues.Both univariate and multivariate logistic regression analyses were employed to ascertain the determinants influencing the emergence of adenomatous polyps.From these analyses,a predictive nomogram was constructed to forecast the occurrence of adenomatous polyps,and evaluations on the discriminative capacity,calibration,and clinical utility of the model were conducted.Results The adenomatous polyp group exhibited markedly elevated levels of glucose,insulin,FGF-19,and IGF-1,with respective concentrations of(8.67±2.70)mmol/L,(12.72±7.69)μU/L,2.20±1.88,and 1.36±0.69.These figures were significantly higher compared to the inflammatory polyp group,which showed levels of(5.51±0.72)mmol/L,(5.49±2.68)μU/L,0.53±0.97,and 0.41±0.46,respectively,P=0.001.Multivariate logistic regression revealed that the relative expression of IGF-1 served as an independent risk factor for the development of colorectal adenomatous polyps(OR=5.622,95%CI:1.085-29.126).The nomogram displayed a C-index of 0.849,indicating substantial discriminative capability.The calibration curve affirmed the model's accuracy in aligning predicted probabilities with actual outcomes,and the clinical decision curve demonstrated thepractical clinical applicability of the model.Conclusions There was a significant correlation between the occurrence of colorectal adenomatous polyps and glucose metabolic pathways.Individuals with diabetes showed a higher propensity t

关 键 词：腺瘤性息肉 糖尿病 成纤维细胞生长因子19 胰岛素样生长因子1 

分 类 号：R735.34[医药卫生—肿瘤]