手术标本中生物活性分子表达对结直肠癌腹腔镜术后早期复发转移的预警价值  

Warning value of bioactive molecule expression in surgical specimens for early recurrence and metastasis of colorectal cancer after laparoscopic surgery

作　　者：郭俊宇[1] 廖驰林[2] 郭厚基[1] GUO Junyu;LIAO Chilin;GUO Houji(Anorectal Department,the Affiliated Hospital of Youjiang Medical University for Nationalities,Baise,Guangxi,533000;Cardiovascular Department,Baise People′s Hospital,Baise,Guangxi,533000)

机构地区：[1]右江民族医学院附属医院肛肠科,广西百色533000 [2]百色市人民医院心血管内科,广西百色533000

出　　处：《实用临床医药杂志》2025年第2期57-62,共6页Journal of Clinical Medicine in Practice

基　　金：2021年度百色科学研究与技术开发课题(百科20213214);2022年度广西高校中青年教师科研基础能力提升项目(2022KY0530)。

摘　　要：目的探讨联合检测手术标本中磷酸甘油酸变位酶1(PGAM1)、微小核糖核酸-433-3p(miR-433-3p)、细胞周期蛋白依赖性激酶1(CDK1)表达对结直肠癌(CRC)腹腔镜术后早期复发转移的预警价值。方法回顾性分析120例CRC腹腔镜手术患者的临床资料,根据术后1年复发转移发生情况分为发生组31例和未发生组89例。比较2组临床资料及手术标本中PGAM1、miR-433-3p、CDK1表达;采用Logistic回归分析探讨PGAM1、miR-433-3p、CDK1对CRC腹腔镜术后复发转移的影响;采用受试者工作特征(ROC)曲线分析PGAM1、miR-433-3p、CDK1单独及联合预测腹腔镜术后复发转移的价值,并进行外部验证。结果发生组PGAM1 mRNA、CDK1 mRNA水平高于未发生组,miR-433-3p水平低于未发生组,差异有统计学意义(P<0.05)。Logistic回归分析显示,PGAM1 mRNA(OR=1.387,95%CI:1.025~1.877)、miR-433-3p(OR=0.543,95%CI:0.319~0.924)、CDK1 mRNA(OR=1.353,95%CI:1.108~1.651)均是CRC腹腔镜术后复发转移的独立影响因素(P<0.05)。ROC曲线分析显示,PGAM1 mRNA、miR-433-3p、CDK1 mRNA联合预测CRC腹腔镜术后复发转移的曲线下面积(AUC)为0.904(95%CI:0.836~0.950),优于各指标单独预测效能。个体值预测结果显示,诊断准确率为84.17%的条件下,CRC患者在腹腔镜术后会发生早期复发转移;外部验证显示,联合预测结果与临床实际结果的Kappa值为0.864(95%CI:0.611~0.984),一致性较好。结论手术标本中PGAM1、miR-433-3p、CDK1表达均是CRC患者腹腔镜术后早期复发转移的独立影响因素,联合检测对术后复发转移具有较高预测价值。Objective To explore the warning value of expression of phosphoglycerate mutase 1(PGAM1),microRNA-433-3p(miR-433-3p)and cyclin-dependent kinase 1(CDK1)in surgical specimens for early recurrence and metastasis after laparoscopic surgery for colorectal cancer(CRC).Methods Clinical materials of 120 patients with laparoscopic surgery for CRC were retrospectively analyzed.Based on the incidence status of recurrence and metastasis within one year after surgery,the patients were divided into recurrence group(n=31)and non-recurrence group(n=89).The clinical materials and the expression levels of PGAM1,miR-433-3p,and CDK1 in surgical specimens were compared between the two groups.Logistic regression analysis was conducted to explore the impacts of PGAM1,miR-433-3p and CDK1 on recurrence and metastasis after laparoscopic surgery for CRC.Receiver operating characteristic(ROC)curve was drawn to analyze the values of PGAM1,miR-433-3p and CDK1 alone as well as their combination for predicting recurrence andmetastasis after laparoscopic surgery,and external validation was performed.Results The levels of PGAM1 mRNA and CDK1 mRNA in the recurrence group were significantly higher than those in the non-recurrence group,while the level of miR-433-3p was significantly lower(P<0.05).Logistic regression analysis showed that PGAM1 mRNA(OR=1.387,95%CI,1.025 to 1.877),miR-433-3p(OR=0.543,95%CI,0.319 to 0.924),and CDK1 mRNA(OR=1.353,95%CI,1.108 to 1.651)were all independent factors associated with recurrence and metastasis after laparoscopic surgery for CRC(P<0.05).ROC curve analysis showed that the area under the curve(AUC)for the combined prediction of recurrence and metastasis after laparoscopic surgery for CRC by PGAM1 mRNA,miR-433-3p,and CDK1 mRNA was 0.904(95%CI,0.836 to 0.950),which was superior to the predictive performance of each indicator alone.Individual value prediction results indicated that CRC patients would experience early recurrence and metastasis after laparoscopic surgery under the condition of a diagnostic accuracy ra

关 键 词：磷酸甘油酸变位酶1 微小RNA-433-3p 细胞周期蛋白依赖性激酶1 结直肠癌 腹腔镜手术 复发 转移 预测价值 

分 类 号：R735.3[医药卫生—肿瘤] R730.1[医药卫生—临床医学] R446.11