血清Cripto-1、GGT水平对肾癌患者术后预后的评估价值研究  

Evaluation Value of Serum Cripto-1 and GGT Levels on Postoperative Prognosis of Patients with Renal Carcinoma

作　　者：张超 周理 庞宸 ZHANG Chao;ZHOU Li;PANG Chen(Nanyang Nanshi Hospital,Nanyang,473000)

机构地区：[1]河南省南阳南石医院,473000

出　　处：《实用癌症杂志》2025年第1期61-66,71,共7页The Practical Journal of Cancer

摘　　要：目的探究血清畸胎瘤衍生生长因子-1(Cripto-1)、γ-谷氨酰转肽酶(GGT)在肾癌患者手术疗效监测及预后评估中的价值。方法选取110例肾癌患者为研究对象(研究组),均行肾癌根治术治疗。另选取健康志愿者110例作为对照组。检测所有受试者血清Cripto-1、GGT水平,研究组患者术后随访5年,根据随访情况将患者分为预后不良组和预后良好组。收集肾癌患者临床资料,分析影响肾癌患者预后不良危险因素,绘制受试者工作特征(ROC)曲线分析血清Cripto-1、GGT水平对肾癌患者术后预后不良的预测价值。采用Kaplan-Meier法绘制生存曲线,分析组间生存率差异。结果研究组术前血清Cripto-1、GGT水平高于对照组(P<0.05)。研究组术后血清Cripto-1、GGT水平低于术前(P<0.05)。随访期间,110例患者中有8例患者失访,失访率为7.27%(8/110),102例患者中20例患者发生死亡,死亡率19.61%(20/102)。预后不良组血清Cripto-1、GGT水平高于预后良好组(P<0.05)。与低Cripto-1组相比,高Cripto-1组患者死亡率更高(P<0.05),与低GGT组相比,高GGT组患者死亡率更高(P<0.05)。COX回归分析结果显示Cripto-1≥4.02 ng/ml、GGT≥129 U/L、肿瘤直径>3 cm、病理分期(Ⅲ~Ⅳ期)、远处转移、Fuhrman分级(Ⅲ~Ⅳ级)是影响肾癌患者术后预后不良的独立危险因素(P<0.05)。血清Cripto-1、GGT水平联合检测预测肾癌患者术后预后不良的AUC(95%CI)、敏感度、特异度分别为0.815(0.730~0.901)、95.00%、68.30%。结论血清Cripto-1、GGT水平在肾癌患者体内异常高表达,可用于肾癌根治术疗效监测,且上述指标联合检测对肾癌患者术后预后不良具有较高的预测价值。Objective To explore the value of serum teratoma-derived growth factor-1(Cripto-1)and gamma-glutamyltranspeptidase(GGT)in monitoring the surgical efficacy and evaluating the prognosis of patients with renal cancer.Methods A total of 110 patients with renal carcinoma were selected as the study subjects(study group),all of whom underwent radical nephrectomy.Another 110 healthy volunteers were selected as the control group.Serum Cripto-1 and GGT levels of all subjects were detected.Patients in the study group were followed up for 5 years after surgery,and patients were divided into poor prognosis group and good prognosis group according to the follow-up.Clinical data of patients with renal cancer were collected,risk factors affecting adverse prognosis of patients with renal cancer were analyzed,and receiver operating characteristic(ROC)curves were drawn to analyze the predictive value of serum Cripto-1 and GGT levels on postoperative adverse prognosis of patients with renal cancer.Survival curve was drawn by Kaplan-Meier method to analyze the difference of survival rate between groups.Results The levels of serum Cripto-1 and GGT in the study group were higher than those in the control group(P<0.05).The levels of serum Cripto-1 and GGT in the study group after operation were lower than those before operation(P<0.05).During the follow-up period,8 out of 110 patients were lost to follow-up,with a loss rate of 7.27%(8/110).20 out of 102 patients died,with a mortality rate of 19.61%(20/102).The levels of serum Cripto-1 and GGT in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Compared with low Cripto-1 group,patients with high Cripto-1 group had higher mortality(P<0.05),and patients with high GGT group had higher mortality than patients with low GGT group(P<0.05).COX regression analysis showed that Cripto-1≥4.02 ng/ml,GGT≥129 U/L,tumor diameter>3 cm,pathological stage(Ⅲ~Ⅳ),distant metastasis,and Fuhrman grade(Ⅲ~Ⅳ)were independent risk factors for poor prognosis of patients

关 键 词：畸胎瘤衍生生长因子-1 Γ-谷氨酰转肽酶 肾癌 肾癌根治术 疗效监测 预后 

分 类 号：R737.11[医药卫生—肿瘤]