老年早期胃癌患者血清s-FH-Ab、ProGRP、PPIH水平特征与ESD术后临床转归的相关性研究  

A study on correlation between serum levels of s-FH-Ab,ProGRP and PPIH and clinical outcomes in elderly patients with early gastric cancer after ESD surgery

作　　者：王晓龙 陈元斌 Wang Xiaolong;Chen Yuanbin(Department of General Surgery,People's Hospital of Hai'an City,Hai'an,Jiangsu,226600,P.R.China)

机构地区：[1]海安市人民医院普外科,江苏海安226600

出　　处：《老年医学与保健》2025年第1期61-68,共8页Geriatrics & Health Care

摘　　要：目的探讨老年早期胃癌患者血清富马酸水合酶自身抗体(s-FH-Ab)、胃泌素释放肽前体(ProGRP)、肽基脯氨酸顺反异构酶(PPIH)水平特征与内镜黏膜下剥离术(ESD)术后临床转归的相关性。方法选取2017年7月—2021年7月就诊于海安市人民医院的162例老年早期胃癌患者作为研究对象。所有患者均接受ESD手术治疗,术后随访至少3年。根据患者术后肿瘤复发情况及生存情况划分为临床转归良好组(n=131)和临床转归不良组(n=31)。比较2组临床资料、围术期(术前、术后7 d)血清s-FH-Ab、ProGRP、PPIH水平特征,通过ROC分析确定患者血清s-FH-Ab、ProGRP、PPIH水平的截断值,通过K-M生存曲线、Cox回归分析评价血清s-FH-Ab、ProGRP、PPIH与老年早期胃癌患者ESD术后临床转归不良的影响。结果术后7 d,老年早期胃癌患者血清s-FH-Ab、ProGRP、PPIH水平均低于手术治疗前(P<0.05);术后7 d,临床转归不良组血清s-FH-Ab、ProGRP、PPIH水平均高于临床转归良好组(P<0.05);K-M生存曲线、单因素及多因素Cox回归分析均表明,术后7 d血清s-FH-Ab、ProGRP、PPIH水平升高均是老年早期胃癌患者ESD术后临床转归不良的重要危险因素(P<0.05);ROC曲线分析表明,血清s-FH-Ab、ProGRP、PPIH联合预测老年早期胃癌患者ESD术后临床转归不良的曲线下面积(AUC)(95%CI)=0.909(0.854~0.963),该预测模型具有较高预测效能。结论老年早期胃癌患者血清s-FH-Ab、ProGRP、PPIH水平特征均可能与ESD术后临床转归有关,且对老年早期胃癌患者不良临床转归可能有较高联合预测效能,因此具有一定的临床参考价值。Objective To investigate the correlation between serum levels of fumarate hydratase autoantibody(s-FH-Ab),pro-gastrin-releasing peptide(ProGRP),and peptidyl-prolyl cis-trans isomerase(PPIH)and clinical outcomes in elderly patients with early gastric cancer(EGC)after endoscopic submucosal dissection(ESD)surgery.Methods 162 elderly EGC patients admitted to People's Hospital of Hai'an City from July 2017 to July 2021 were selected as the study subjects.All patients underwent ESD surgery and were followed up for at least 3 years postoperatively.They were divided into good clinical outcome group(n=131)and adverse clinical outcome group(n=31)according to postoperative tumor recurrence and survival status.The clinical data and serum levels of s-FH-Ab,ProGRP and PPIH in the perioperative period(7 d before and 7 d after surgery)were compared between the two groups.The cut-off values of serum s-FH-Ab,ProGRP and PPIH were determined by ROC analysis.Kaplan-Meier(K-M)survival curve and Cox regression analysis were used to evaluate the effects of serum levels of s-FH-Ab,ProGRP and PPIH on the adverse clinical outcomes in elderly EGC patients after ESD surgery.Results Seven days after surgery,the serum levels of s-FH-Ab,ProGRP and PPIH in elderly EGC patients were significantly lower than before surgery(P<0.05).On the 7th day after surgery,the serum levels of s-FH-Ab,ProGRP and PPIH in the adverse clinical outcome group were significantly higher than those in the good clinical outcome group(P<0.05).The K-M survival curve,univariate and multivariate Cox regression analysis all showed that the elevated serum levels of s-FH-Ab,ProGRP,and PPIH at 7 days after surgery were important risk factors for adverse clinical outcomes in elderly EGC patients after ESD surgery(P<0.05),ROC curve analysis showed that the combined prediction of the area under the curve(AUC)(95%CI)of s-FH-Ab,ProGRP and PPIH in elderly EGC patients after ESD surgery was 0.909(0.8540.963),indicating that this prediction model had a high predictive performance.Conclu

关 键 词：老年 胃癌 血清富马酸水合酶自身抗体 胃泌素释放肽前体 肽基脯氨酸顺反异构酶 内镜黏膜下剥离术 

分 类 号：R73[医药卫生—肿瘤]