胃癌根治术病人术前血清sTWEAK、YKL-40水平对预后的影响  

Preoperative serum levels of sTWEAK and YKL-40 in patients with gastric cancer undergoing radical surgery and their impact on prognosis

作　　者：孙东跃 王旭青[1] SUN Dongyue;WANG Xuqing(Department of Gastrointestinal Surgery,Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu 212001,China)

机构地区：[1]江苏大学附属医院胃肠外科,江苏镇江212001

出　　处：《安徽医药》2025年第4期729-732,共4页Anhui Medical and Pharmaceutical Journal

基　　金：江苏省老年健康科研项目(LKZ2023012)。

摘　　要：目的探讨胃癌根治术病人术前血清可溶性肿瘤坏死因子样凋亡弱诱导因子(sTWEAK)、甲壳质酶蛋白40(YKL-40)表达水平及其对预后的影响。方法选取2017年10月至2019年12月在江苏大学附属医院接受诊治的122例胃癌根治术病人,并收集所有病人临床资料。采用酶联免疫吸附分析(ELISA)对胃癌根治术病人术前、术后血清sTWEAK、YKL-40水平进行检测;术后随访3年,根据术后生存状况分为预后良好组(n=70)和预后不良组(n=52)。比较各组间血清sTWEAK、YKL-40水平与基本资料;Cox回归分析胃癌根治术预后影响因素;受试者操作特征曲线(ROC曲线)分析sTWEAK、YKL-40对胃癌根治术预后的预测价值。结果胃癌根治术前病人血清sTWEAK(258.47±60.27)ng/L、YKL-40(106.41±30.47)μg/L水平显著高于术后(200.01±41.33)ng/L、(55.16±6.79)μg/L(P<0.05);与预后良好组相比,预后不良组术前血清sTWEAK、YKL-40水平显著升高(P<0.05);预后良好组与预后不良组在TNM分期、组织学类型上差异有统计学意义(P<0.05);TNM分期、组织学类型、sTWEAK、YKL-40为胃癌根治术预后的独立危险因素(P<0.05);ROC曲线结果显示术前sTWEAK、YKL-40单独评估胃癌根治术病人预后的AUC分别为0.74、0.74,灵敏度分别为64.0%、80.0%,特异度分别为36.2%、36.9%,两者联合评估的AUC为0.86,灵敏度、特异度分别为80.0%、60.6%。结论胃癌根治术后病人血清sTWEAK、YKL-40水平均显著降低,且术前血清sTWEAK、YKL-40是影响胃癌根治术病人预后的重要因素,因此sTWEAK、YKL-40在胃癌根治术病人血清中的表达水平可预测病人生存状况。Objective To investigate the expression levels of serum soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK)and chitinase protein 40(YKL-40)in patients with GC undergoing radical surgery before operation,and their impact on prognosis.Methods A total of 122 gastric cancer(GC)patients who underwent radical gastrectomy in Affiliated Hospital of Jiangsu University from October 2017 to December 2019 were collected as the study subjects(GC group),and collect clinical data of patients were collected.Enzyme linked immunosorbent assay(ELISA)was applied to detect the serum levels of sTWEAK and YKL-40 in GC patients before and after surgery.Patients with GC were followed up for 3 years after surgery,and the patients were divided into the group with good prognosis(n=70)and the group with poor prognosis(n=52)according to the survival of GC patients after surgery.Serum sTWEAK and YKL-40 levels and basic data were compared between groups;Cox regression analysis was applied to analyze the prognostic factors in GC patients.The receiver operating characteristic curve(ROC curve)of subjects was used to analyze the predictive value of sT-WEAK and YKL-40 on the prognosis of GC patients.Results The serum levels of sTWEAK(258.47±60.27)ng/L and YKL-40(106.41±30.47)μg/L in patients before radical GC resection were significantly higher than those in the postoperative group(200.01±41.33)ng/L,(55.16±6.79)μg/L(P<0.05);Compared with the group with good prognosis,the preoperative serum levels of sTWEAK and YKL-40 in GC patients in the poor prognosis group were significantly increased(P<0.05);There were significant differences in TNM stage and histological type between the good prognosis group and the poor prognosis group(P<0.05).TNM stage,histological type,serum sTWEAK and YKL-40 were independent risk factors affecting the prognosis of GC patients(P<0.05);The ROC curve results showed that the AUCs of preoperative sTWEAK and YKL-40 alone were 0.74 and 0.74,with specificities of 64.0%and 80.0%,specificities of 36.2%and 36.9%

关 键 词：胃肿瘤 胃切除术 肿瘤坏死因子样弱凋亡诱导物 甲壳质酶蛋白40(YKL-40) 预后 

分 类 号：R735.2[医药卫生—肿瘤]