血清GH和AGR2水平预测功能性垂体腺瘤患者术后复发的临床价值  

Clinical value of serum GH and AGR2 levels in predicting postoperative recurrence in patients with functional pituitary adenoma

作　　者：徐笑 魏栋 王协锋 陈功 XU Xiao;WEI Dong;WANG Xiefeng;CHEN Gong(Department of Neurosurgery,Jiangsu Provincial People's Hospital,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]江苏省人民医院,南京医科大学第一附属医院神经外科,江苏南京210029

出　　处：《热带医学杂志》2024年第8期1145-1149,F0004,共6页Journal of Tropical Medicine

基　　金：国家自然科学基金(82172667)。

摘　　要：目的分析血清生长激素(GH)、人前梯度蛋白2(AGR2)水平对功能性垂体腺瘤患者术后复发情况的预测价值。方法选取2021年3月-2023年3月江苏省人民医院诊治的功能性垂体腺瘤患者191例,将患者分为复发组(38例)与未复发组(153例),比较两组血清GH、AGR2水平,复发组血清GH与AGR2水平相关性采用Pearson分析,影响功能性垂体腺瘤患者预后的因素分析采用logistic回归分析;血清GH、AGR2水平对功能性垂体腺瘤患者预后判断价值采用受试者工作特征(ROC)曲线。结果复发组血清GH、AGR2水平皆高于未复发组,差异有统计学意义(t=7.316、7.233,P均<0.05)。复发组血清GH与AGR2成正相关(r=0.449,P=0.005)。复发组与未复发组肿瘤分期差异有统计学意义(χ^(2)=4.261,P<0.05),复发组肿瘤分期Ⅲ~Ⅳ期占比多于未复发组,而Ⅰ~Ⅱ期占比少于未复发组。肿瘤分期、血清GH、AGR2是影响功能性垂体腺瘤患者预后的相关因素(OR=2.736、1.827、1.925,P<0.05)。采用血清GH预测功能性垂体腺瘤患者预后的敏感性为76.32%、曲线下面积(AUC)为0.845(95%CI=0.776~0.913),采用血清AGR2预测功能性垂体腺瘤患者预后的敏感性为78.95%、AUC为0.843(95%CI=0.774~0.912),血清GH联合血清AGR2预测功能性垂体腺瘤患者预后的敏感性和AUC较高,分别为92.11%、0.938(95%CI=0.903~0.973),联合检测对功能性垂体腺瘤患者预后的预测价值高于两个指标单独检测(Z两者联合vs.GH=3.200,P=0.001;Z_(两者联合vs.AGR2)=3.114,P=0.002)。结论功能性垂体腺瘤患者血清GH、AGR2水平升高不利于患者预后,两者联合可对功能性垂体腺瘤患者术后复发情况预测提供一些参考。Objective To analyze the predictive value of serum growth hormone(GH)and anterior gradient⁃2(AGR2)levels on postoperative recurrence in patients with functional pituitary adenoma.Methods From March 2021 to March 2023,191 patients with functional pituitary adenoma treated in our hospital were selected and divided into recurrent group(38 cases)and non⁃recurrent group(153 cases).The serum GH and AGR2 levels of the two groups were compared.The correlation between serum GH and AGR2 levels in the recurrent group was analyzed using Pearson analysis,and the factors affecting the prognosis of patients with functional pituitary adenoma were analyzed using logistic regression analysis;the prognostic value of serum GH and AGR2 levels in patients with functional pituitary adenoma was evaluated using receiver operating characteristic(ROC)analysis.Results The serum GH and AGR2 levels in the recurrent group were significantly higher than those in the non⁃recurrent group,the differences were statistically significant(t=7.316,7.233;all P<0.05).There was a positive correlation between serum GH and serum AGR2 in the recurrent group(r=0.449,P=0.005).There was an obvious difference in tumor staging between the recurrent group and the non⁃recurrent group,the difference was statistically significant(χ^(2)=4.261,P<0.05).The proportion of tumor staging stagesⅢ⁃Ⅳin the recurrent group was higher than that in the non⁃recurrent group,while the proportion of stagesⅠ⁃Ⅱwas lower than that in the non⁃recurrent group.Tumor staging,serum GH level,and serum AGR2 level were related factors affecting the prognosis of patients with functional pituitary adenoma(OR=2.736,1.827,1.925,P<0.05).The sensitivity of serum GH in predicting the prognosis of patients with functional pituitary adenoma was 76.32%,and the area under the curve(AUC)was 0.845(95%CI:0.776-0.913);the sensitivity of serum AGR2 level in predicting the prognosis of patients with functional pituitary adenoma was 78.95%,and the AUC was 0.843(95%CI:0.774-0.912),the sen

关 键 词：生长激素 人前梯度蛋白2 功能性垂体腺瘤 术后复发 

分 类 号：R736.4[医药卫生—肿瘤]