血清CXCL12及其受体CXCR4、CXCR7与结肠癌患者临床病理特征及术后肝转移的关系研究  

Relationship between serum CXCL12 and its receptors CXCR4 and CXCR7 with clinicopathological features and postoperative liver metastasis in patients with colon cancer

作　　者：石彦科 颜廷启[1] 孙伟涛[1] 陈志飞[1] 孙江江[1] 霍浩然[2] 王军委 SHI Yanke;YAN Tingqi;SUN Weitao;CHEN Zhifei;SUN Jiangjiang;HUO Haoran;WANG Junwei(First Department of Emergency Surgery,Handan Municipal Central Hospital,Handan,Hebei 056000,China;Third Department of General Surgery,Handan Municipal Central Hospital,Handan,Hebei 056000,China;Department of Intervention,Handan Municipal Central Hospital,Handan,Hebei 056000,China)

机构地区：[1]河北省邯郸市中心医院急诊外一科,河北邯郸056000 [2]河北省邯郸市中心医院普外三科,河北邯郸056000 [3]河北省邯郸市中心医院介入科,河北邯郸056000

出　　处：《检验医学与临床》2025年第2期178-183,189,共7页Laboratory Medicine and Clinic

基　　金：河北省2024年度医学科学研究课题计划项目(20241159)。

摘　　要：目的探讨血清CXC趋化因子配体12(CXCL12)及其受体CXC趋化因子受体4(CXCR4)、CXC趋化因子受体7(CXCR7)水平与结肠癌患者临床病理特征及术后肝转移的关系。方法选取2017年1月至2019年12月邯郸市中心医院收治的207例结肠癌患者为结肠癌组,另选取同期70例体检健康者为对照组;比较两组血清CXCL12及其受体CXCR4、CXCR7水平差异;分析血清CXCL12及其受体CXCR4、CXCR7水平与结肠癌患者临床病理特征的关系。根据是否出现术后肝转移将患者分为肝转移组和无肝转移组,采用多因素Logistic回归分析结肠癌患者术后肝转移的影响因素,绘制受试者工作特征(ROC)曲线分析各影响因素单项及联合对结肠癌患者术后肝转移的预测价值。结果结肠癌组血清CXCL12、CXCR4、CXCR7水平明显高于对照组(P<0.05)。有脉管侵犯、TNM分期Ⅲ期、有淋巴结转移的结肠癌患者血清CXCL12、CXCR4、CXCR7水平高于无脉管侵犯、TNM分期Ⅰ~Ⅱ期、无淋巴结转移的结肠癌患者(P<0.05)。肝转移组和无肝转移组脉管侵犯、TNM分期、淋巴结转移情况及血清CXCL12、CXCR4、CXCR7水平比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,临床综合体征(脉管侵犯、TNM分期Ⅲ期、淋巴结转移)阳性及血清CXCL12、CXCR4、CXCR7水平升高是结肠癌患者术后肝转移的独立危险因素(P<0.05)。ROC曲线分析结果显示,临床综合体征(脉管侵犯+TNM分期+淋巴结转移)、CXCL12、CXCR4、CXCR7单独以及4项联合应用预测结肠癌患者术后肝转移的曲线下面积(AUC)分别为0.748、0.707、0.723、0.737、0.854,4项联合应用的AUC均大于各指标单独预测的AUC(Z=2.057、2.337、2.237、2.137,P=0.042、0.021、0.028、0.035)。结论结肠癌患者血清CXCL12及其受体CXCR4、CXCR7水平呈异常高表达,与结肠癌患者脉管侵犯、TNM分期、淋巴结转移等恶性临床病理特征有关。血清CXCL12及其受体CXCR4、CXCR7水平是Objective To investigate the relationship between serum CXC chemokine ligand 12(CXCL12)and its receptor CXC chemokine receptor 4(CXCR4)and CXC chemokine receptor 7(CXCR7)levels with the clinicopathological features and postoperative liver metastasis in the patients with colon cancer.Methods A total of 207 patients with colon cancer admitted and treated in Handan Municipal Central Hospital from January 2017 to December 2019 were selected as the colon cancer group,and 70 healthy subjects undergoing physical examination during the same period were selected as the control group.The difference of serum CXCL12 and its receptors CXCR4 and CXCR7 levels were compared between the two groups.The relationship between serum CXCL12 and its receptors CXCR4 and CXCR7 levels with the clinicopathological features of the patients with colon cancer was analyzed.The patients were divided into the liver metastasis group and non-liver metastasis group according to whether or not postoperative liver metastasis occurred.The multivariate Logistic regression analysis was used to analyze the influencing factors of postoperative liver metastasis in the patients with colon cancer.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of single influencing factor and combined influencing factors for postoperative liver metastasis in the patients with colon cancer.Results The levels of serum CXCL12,CXCR4 and CXCR7 in the colon cancer group were higher than those in the control group(P<0.05).The serum CXCL12,CXCR4 and CXCR7 levels in colon cancer patients with vascular invasion,TNM stageⅢand lymph node metastasis were higher than those in colon cancer patients with non-vascular invasion,TNM stageⅠ-Ⅱand non-lymph node metastasis(P<0.05).There were statistically significant differences in vascular invasion,TNM stage,lymph node metastasis and serum CXCL12,CXCR4 and CXCR7 levels between the liver metastasis group and the non-liver metastasis group(P<0.05).The multivariate Logistic regression analysis showed t

关 键 词：结肠癌 CXCL12 CXCR4 CXCR7 临床病理特征 肝转移 

分 类 号：R735.35[医药卫生—肿瘤] R446.1[医药卫生—临床医学]