血清IGFBP-1、IGFBP-7与SiewertⅡ、Ⅲ型食管胃结合部腺癌患者临床病理参数和预后的关系  

Relationship between serum IGFBP-1,IGFBP-7 and clinicopathological parameters and prognosis of Siewert typeⅡandⅢpatients with esophagogastric junction adenocarcinoma

作　　者：刘诺凡 赵瑞兴[2] 任更朴[2] 田金静 田佳 LIU Nuofan;ZHAO Ruixing;REN Gengpu;TIAN Jinjing;TIAN Jia(Department of Clinical Laboratory,the Second People′s Hospital of Liaocheng City,Liaocheng,Shandong 252699,China;Department of Thoracic Surgery,the Second People′s Hospital of Liaocheng City,Liaocheng,Shandong 252699,China;Department of Pathology,the Second People′s Hospital of Liaocheng City,Liaocheng,Shandong 252699,China)

机构地区：[1]山东省聊城市第二人民医院检验科,山东聊城252699 [2]山东省聊城市第二人民医院胸外科,山东聊城252699 [3]山东省聊城市第二人民医院病理科,山东聊城252699

出　　处：《检验医学与临床》2024年第18期2717-2723,共7页Laboratory Medicine and Clinic

基　　金：2020年度山东省医药卫生科技发展计划项目(20204120342)。

摘　　要：目的分析血清胰岛素生长因子结合蛋白(IGFBP)-1、IGFBP-7与SiewertⅡ、Ⅲ型食管胃结合部腺癌(AEG)患者临床病理参数和预后的关系。方法选取2019年1月至2020年11月山东省聊城市第二人民医院收治的264例SiewertⅡ、Ⅲ型AEG患者作为AEG组,另选取同期在山东省聊城市第二人民医院体检中心体检的112例健康志愿者作为对照组。检测所有研究对象的血清IGFBP-1、IGFBP-7水平并统计AEG患者的临床病理参数。随访患者3年生存情况,根据生存情况将患者分为死亡组和存活组。以IGFBP-1、IGFBP-7的均值界限将患者分为高水平IGFBP-1组、低水平IGFBP-1组、高水平IGFBP-7组、低水平IGFBP-7组。采用Kaplan-Meier生存曲线分析IGFBP-1、IGFBP-7水平与SiewertⅡ、Ⅲ型AEG患者预后的关系。采用多因素Logistic回归分析SiewertⅡ、Ⅲ型AEG患者死亡的危险因素。绘制受试者工作特征(ROC)曲线分析血清IGFBP-1、IGFBP-7对SiewertⅡ、Ⅲ型AEG患者死亡的预测价值。结果AEG组血清IGFBP-1、IGFBP-7水平低于对照组,差异均有统计学意义(P<0.05)。肿瘤最大径≥4 cm、低中分化患者血清IGFBP-1、IGFBP-7水平分别低于肿瘤最大径<4 cm、高分化患者,差异均有统计学意义(P<0.05)。随访期间死亡75例,存活189例。高水平IGFBP-1组、低水平IGFBP-1组、高水平IGFBP-7组、低水平IGFBP-7组患者分别有129、135、136、128例。低水平IGFBP-1组3年生存率为59.26%,低于高水平IGFBP-1组的81.40%(P=0.017)。低水平IGFBP-7组3年生存率为57.81%,低于高水平IGFBP-7组的81.26%(P=0.011)。死亡组低中分化、淋巴管侵犯、壁外血管侵犯患者比例高于存活组,血清IGFBP-1、IGFBP-7水平低于存活组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,低中分化程度、淋巴管侵犯、IGFBP-1水平降低、IGFBP-7水平降低是SiewertⅡ、Ⅲ型AEG患者死亡的危险因素(P<0.05)。ROC曲线分析结果显示,IGFBP-1、IGFBP-7Objective To analyze the relationship between serum insulin growth factor binding protein(IGFBP-1),IGFBP-7 and clinicopathological parameters and prognosis of Siewert typeⅡandⅢpatients with esophagogastric junction adenocarcinoma(AEG).Methods A total of 264 patients with Siewert typeⅡandⅢAEG treated in the Second People′s Hospital of Liaocheng City from January 2019 to November 2020 were selected as AEG group,and 112 healthy volunteers who underwent physical examination in the physical examination center of the Second People′s Hospital of Liaocheng City during the same period were selected as control group.The serum levels of IGFBP-1 and IGFBP-7 in all subjects were detected,and clinicopathological parameters of AEG patients were analyzed.Patients were followed up for 3 years and divided into death group and survival group according to survival situation.Patients were divided into high level IGFBP-1 group,low level IGFBP-1 group,high level IGFBP-7 group and low level IGFBP-7 group according to the mean limits of IGFBP-1 and IGFBP-7.Kaplan-Meier survival curve was used to analyze the relationship between IGFBP-1 and IGFBP-7 levels and the prognosis of Siewert typeⅡandⅢAEG patients.Multivariate Logistic regression was used to analyze the risk factors of death in SiewertⅡandⅢAEG patients.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum IGFBP-1 and IGFBP-7 for the death of Siewert typeⅡandⅢAEG patients.Results The levels of serum IGFBP-1 and IGFBP-7 in AEG group were lower than those in control group,and the differences were statistically significant(P<0.05).Serum IGFBP-1 and IGFBP-7 levels in patients with maximum tumor diameter≥4 cm and low to medium differentiation were lower than those in patients with maximum tumor diameter<4 cm and highly differentiation respectively,and the differences were statistically significant(P<0.05).During the follow-up,75 patients died and 189 survived.There were 129,135,136 and 128 patients in high level IGFBP-1

关 键 词：食管胃结合部腺癌 胰岛素生长因子结合蛋白-1 胰岛素生长因子结合蛋白-7 临床病理参数 预后 

分 类 号：R735.1[医药卫生—肿瘤] R735.2[医药卫生—临床医学]