早期结肠癌患者血清LDH、TBA表达与内镜黏膜下剥离术术后复发转移的关系  

Correlations of expression of serum LDH and TBA with postoperative recurrence and metastasis in early colon cancer after endoscopic submucosal dissection

作　　者：刘剑英 李英 Liu Jianying;Li Ying(Department of Clinical Laboratory,Nanshi Hospital of Nanyang,Nanyang 473000,China)

机构地区：[1]南阳南石医院检验科,南阳473000

出　　处：《中国实用医刊》2025年第1期42-46,共5页Chinese Journal of Practical Medicine

摘　　要：目的分析早期结肠癌患者血清乳酸脱氢酶(LDH)、总胆汁酸(TBA)表达与内镜黏膜下剥离术(ESD)术后复发转移的关系。方法前瞻性抽取2021年1月至2022年11月南阳南石医院收治的早期结肠癌患者98例纳入观察组,另抽取同期体检证实健康者98例纳入对照组。测定所有对象血清LDH、TBA、肿瘤标志物[癌胚抗原(CEA)、糖类抗原19-9(CA19-9)]水平。观察组接受ESD治疗,术后随访1年,依据术后复发转移情况将其分为复发转移组与未复发转移组,分析术前血清LDH、TBA表达与早期结肠癌ESD术后复发和转移的关系及其对复发转移的交互作用。结果观察组血清LDH、TBA、CEA及CA19-9水平高于对照组(P<0.05)。观察组随访1年,98例早期结肠癌患者ESD术后复发转移23例(23.47%),未复发转移75例(76.53%)。复发转移组血清LDH、TBA、CEA、CA19-9水平高于未复发转移组(P<0.05)。Logistic回归分析模型结果显示,早期结肠癌ESD术后复发转移者术前血清LDH、TBA、CEA、CA19-9表达上调可能是术后复发转移的危险因素(OR>1,P<0.05)。LDH、TBA对早期结肠癌患者ESD术后复发转移的发生存在正向交互作用,二者均高表达时复发转移风险是二者均低表达时的61.091倍,协同效应为二者单独存在产生效应之和的20.125倍(交互作用指数为20.125)。结论早期结肠癌患者术前血清LDH、TBA表达上调可能是ESD术后复发转移的危险因素,二者可协同增加结肠癌复发转移的风险。ObjectiveTo analyze the correlations of the expressions of serum lactate dehydrogenase(LDH)and total bile acid(TBA)with recurrence and metastasis in early colon cancer after endoscopic submucosal dissection(ESD).MethodsNinety-eight patients with early-stage colon cancer admitted to Nanshi Hospital of Nanyang from January 2021 to November 2022 were prospectively selected as the observation group,and 98 healthy people confirmed by physical examination during the same period were selected as the control group.The levels of serum LDH,TBA,tumor markers including carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)in all subjects were detected.Patients in the observation group were treated by ESD,and were followed up for 1 year after surgery.And the observation group was divided into the recurrence-metastasis group and non recurrence-metastasis group according to the postoperative recurrence and metastasis after ESD treatment.The correlations of serum preoperative expressions of LDH and TBA with recurrence and metastasis after ESD for early colon cancer were analyzed;moreover,the interactions on recurrence and metastasis were analyzed.ResultsThe serum levels of LDH,TBA,CEA and CA19-9 in the observation group were higher than those in the control group(P<0.05).During 1-year follow-up,23(23.47%)of 98 patients with early-stage colon cancer in the observation group had recurrence and metastasis after ESD surgery,and 75(76.53%)patients had no recurrence or metastasis.The serum levels of LDH,TBA,CEA,and CA19-9 in the recurrence-metastasis group were higher than those in the non recurrence-metastasis group(P<0.05).The results of logistic regression analysis showed that the expressions of LDH,TBA,CEA and CA19-9 were up-regulated in patients with recurrence and metastasis after ESD for early colon cancer,and the preoperative up-regulation of LDH,TBA,CEA and CA19-9 might be risk factors for postoperative recurrence and metastasis(OR>1,P<0.05).Preoperative LDH and TBA had a positive interaction effect on recurrence

关 键 词：结肠癌 内镜黏膜下剥离术 乳酸脱氢酶 总胆汁酸 

分 类 号：R735.35[医药卫生—肿瘤]