血清AFP、HE4、CYFRA21-1水平联合检测对腹腔镜胃癌根治术后复发转移的预测价值  

Predictive value of combined detection of serum AFP,HE4,and CYFRA21-1 levels for recurrence and metastasis after laparoscopic radical gastrectomy for gastric cancer

作　　者：时慧 王丽[1] 高姝鸢 李书彤 Shi Hui;Wang Li;Gao Shu-yuan;Li Shu-tong(Department of Clinical Laboratory,The First People's Hospital of Pingdingshan,Pingdingshan 467000,Henan,China)

机构地区：[1]平顶山市第一人民医院检验科,河南平顶山467000

出　　处：《四川生理科学杂志》2025年第1期15-18,25,共5页

基　　金：河南省医学科技攻关联合共建项目(LHGJ20211076)。

摘　　要：目的:探讨腹腔镜胃癌根治术后复发转移者血清甲胎蛋白(Alpha fetoprotein,AFP)、人附睾蛋白-4(Human epididymis protein-4,HE4)、细胞角蛋白19片段抗原21-1(Cytokerantin-19-fragment antigen 21-1,CYFRA21-1)水平变化,分析其对术后复发转移的预测价值。方法:选取2020年5月~2022年5月于本院接受腹腔镜胃癌根治术治疗的128例胃癌患者为研究组,另匹配同期健康志愿者64例作为对照组。比较两组血清AFP、HE4、CYFRA21-1水平。依据术后1 y内是否发生复发转移分为发生者和未发生者,比较其临床资料及血清AFP、HE4、CYFRA21-1水平。多因素Logistic回归分析术后复发转移的影响因素。受试者工作特征曲线(Receiver operating characteristic,ROC)评价术后2m血清AFP、HE4、CYFRA21-1水平对术后1 y复发转移的预测价值。结果:研究组血清AFP、HE4、CYFRA21-1水平高于对照组(P<0.05)。患者于1 y内发生复发转移37例,未发生复发转移91例。发生者术后2m的血清AFP、HE4、CYFRA21-1水平高于未发生者(P<0.05);TNM分期、淋巴结转移及术后2 mAFP、HE4、CYFRA21-1水平为术后复发转移的独立危险因素,分化程度为术后复发转移的独立保护因素(P<0.05);血清AFP、HE4、CYFRA21-1联合预测术后复发转移的曲线下面积(Area under the curve,AUC)大于单项指标预测(P<0.05)。结论:腹腔镜胃癌根治术后复发转移患者血清AFP、HE4、CYFRA21-1水平升高,联合检测其水平对术后复发转移具有一定预测价值。Objective:To investigate the changes in serum levels of Alpha fetoprotein(AFP),Human epididymis protein-4(HE4),and Cytokerantin-19-fragment antigen 21-1(CYFRA21-1)in patients with recurrent or metastatic gastric cancer after laparoscopic radical gastrectomy,and analyze their predictive value for postoperative recurrence or metastasis.Methods:A total of 128 patients with gastric cancer who underwent laparoscopic radical gastrectomy in our hospital from May 2020 to May 2022 were selected as the study group,and 64 healthy volunteers were matched as the control group.The levels of serum AFP,HE4,and CYFRA21-1 were compared between the two groups.According to whether recurrence and metastasis occurred within one year after surgery,the patients were divided into those who had recurrence and metastasis and those who did not,and their clinical data and serum levels of AFP,HE4,and CYFRA21-1 were compared.Multivariate logistic regression analysis was used to analyze the factors affecting postoperative recurrence and metastasis.The Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum AFP,HE4,and CYFRA21-1 levels for recurrence and metastasis at one year after surgery.Results:The levels of serum AFP,HE4,and CYFRA21-1 in the study group were higher than those in the control group(P<0.05).Thirty-seven patients had recurrence and metastasis within one year,while 91 patients did not.The levels of serum AFP,HE4,and CYFRA21-1 in patients who had recurrence and metastasis two months after surgery were higher than those in patients who did not(P<0.05).TNM staging,lymph node metastasis,and the levels of AFP,HE4,and CYFRA21-12 months after surgery were independent risk factors for postoperative recurrence and metastasis,while differentiation was an independent protective factor for postoperative recurrence and metastasis(P<0.05).The area under the curve(AUC)of serum AFP,HE4,and CYFRA21-1 combined to predict postoperative recurrence and metastasis was greater than that of single indicators(P<0.0

关 键 词：胃癌 复发转移 甲胎蛋白 人附睾蛋白-4 细胞角蛋白19片段抗原21-1 

分 类 号：R735.2[医药卫生—肿瘤]