肺癌胸腔镜根治术标本TCF21、ANGPT1、SSTR2表达及联合检测预测术后复发转移模型构建与验证  

Expression and combined detection of TCF21,ANGPT1 and SSTR2 in thoracoscopic radical operation samples for lung cancer predicted postoperative recurrence and metastasis model construction and verification

作　　者：贠俊茹 刘勇世 倪云峰 赵阿红 滕鑫 王娟 YUN Junru;LIU Yongshi;NI Yunfeng;ZHAO Ahong;TENG Xin;WANG Juan(The Second Affiliated Hospital of Air Force Military Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学第二附属医院,陕西西安710038

出　　处：《西部医学》2024年第11期1648-1653,共6页Medical Journal of West China

基　　金：空军军医大学第二附属医院院级课题(TDHLKY-2021-04)。

摘　　要：目的探讨肺癌胸腔镜根治术标本中肿瘤转移相关基因转录因子21(TCF21)、血管生成素1(ANGPT1)、生长抑素受体2(SSTR2)表达情况,构建术后复发转移的联合预测模型并进行验证,为临床早期预测术后复发转移提供参考。方法前瞻性选取2020年3月—2022年2月于本院行胸腔镜根治术的149例肺癌患者为研究对象,根据术后1年是否发生复发转移分为复发转移组(n=32)、未复发转移组(n=117)。采用随机森林算法对术后复发转移的特征变量进行筛选与降维。Logistic回归分析术后复发转移的相关影响因素、拟合多个变量联合预测术后复发转移的模型。采用受试者工作特征曲线(ROC)分析各原始协变量及联合预测因子New对术后复发转移的预测价值。结果复发转移组T分期、N分期高于未复发转移组,清扫淋巴结站数、清扫淋巴结N2站数、清扫淋巴结数目及TCF21、ANGPT1、SSTR2表达量低于未复发转移组(P<0.05);随机森林算法显示重要性排序前3的变量分别是TCF21、SSTR2、ANGPT1表达量;Logistic回归分析显示TCF21、SSTR2、ANGPT1表达量为术后复发转移的相关影响因素(P<0.05);联合预测因子New预测术后复发转移的曲线下面积(AUC)大于各原始协变量(P<0.05);个体值预测显示在诊断准确率为95.97%的条件下,该患者不会发生复发转移,且经联合预测因子New验证证实该病例未发生复发转移。结论肺癌胸腔镜根治术术后复发转移患者中TCF21、ANGPT1、SSTR2表达量降低,Logistic回归模型拟合TCF21、ANGPT1、SSTR2生成的联合预测因子对术后复发转移具有一定预测价值。Objective To analyze the expression of tumor metastasis-related gene transcription factor 21(TCF21),ANGPT1(ANGPT1)and somatostatin receptor 2(SSTR2)in thoracoscopic radical resection samples of lung cancer,and to construct and verify the joint prediction model of postoperative recurrence and metastasis,so as to provide reference for early clinical prediction of postoperative recurrence and metastasis.Methods A total of 149 patients with lung cancer who underwent thoracoscopic radical surgery in our hospital from March 2020 to February 2022 were prospectively selected as research objects,and divided into occurrence group and non-occurrence group according to whether recurrence and metastasis occurred one year after surgery.The random forest algorithm was used to screen and reduce the dimension of the characteristic variables of postoperative recurrence and metastasis.Logistic regression was used to analyze the related influencing factors of postoperative recurrence and metastasis,and multiple variables were fitted to predict the postoperative recurrence and metastasis model.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of original covariates and joint predictors new for postoperative recurrence and metastasis.Results The T stage and N stage of the group were higher than those of the group without the disease,the number of lymph node stations,the number of lymph node stations,the number of lymph node stations and the expression levels of TCF21,ANGPT1 and SSTR2 were lower than those of the group without the disease(P<0.05).Random forest algorithm showed that the top 3 variables in importance ranking were TCF21,SSTR2 and ANGPT1 expression.Logistic regression analysis showed that the expression levels of TCF21,SSTR2 and ANGPT1 were related factors for postoperative recurrence and metastasis(P<0.05).Combined predictive factor New predicted that the AUC of postoperative recurrence and metastasis was greater than that of the original covariates(P<0.05).Individual value prediction sh

关 键 词：肺癌 胸腔镜根治术 转录因子21 血管生成素1 生长抑素受体2 复发 转移 LOGISTIC回归模型 

分 类 号：R734.2[医药卫生—肿瘤]