血清REG4及LDH表达与局部进展期胰腺癌患者新辅助化疗效果的关系  

Relationship between serum REG4,LDH expression and neoadjuvant chemotherapy in patients with locally advanced pancreatic cancer

作　　者：郭艳丽 王锦 李颖霞[2] GUO Yan-li;WANG Jin;LI Ying-xia(Department of Gastroenterology,Zhengzhou Yihe Hospital,Zhengzhou 450000,China;Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州颐和医院消化内科,郑州450000 [2]郑州大学第一附属医院消化内科,郑州450000

出　　处：《医药论坛杂志》2025年第3期284-288,共5页Journal of Medical Forum

摘　　要：目的探讨血清人再生基因蛋白Ⅳ(regenerating gene IV,REG4)、乳酸脱氢酶(dehydrogenase,LDH)表达与局部进展期胰腺癌(locally advanced pancreatic cancer,LAPC)患者新辅助化疗(neoadjuvant chemotherapy,NACT)效果的关系。方法回顾性分析2020年8月—2023年8月郑州颐和医院收治的64例LAPC患者的临床资料,所有患者均行NACT(AG方案:白蛋白结合型紫杉醇联合吉西他滨),连续治疗2个周期,参考世界卫生组织制定的实体瘤疗效评价标准(RECIST)评估疗效并将患者分为有效组(34例)、无效组(30例)。比较两组NACT后血清REG4、LDH表达;分析血清REG4、LDH表达与LAPC患者临床病理特征及NACT效果、生存时间的关系。结果有效组NACT 2个周期后血清REG4、LDH表达低于无效组,差异有统计学意义(P<0.05);NACT效果与患者肿瘤直径、分化程度、淋巴结转移有关,差异有统计学意义(P<0.05);绘制ROC曲线,血清REG4、LDH及联合预测NACT效果的AUC均>0.70,有一定的预测价值,且联合预测价值更高;REG4高表达组生存时间与低表达组比较,差异有统计学意义(P<0.05);LDH高表达组生存时间与低表达组比较,差异有统计学意义(P<0.05)。结论血清REG4、LDH表达增高与LAPC患者NACT效果有关,且具有一定的预测价值,早期检测LAPC患者血清REG4、LDH水平对确保NACT效果有积极意义。Objective To investigate the relationship between the expression of human regenerating gene IV(REG4)and lactate dehydrogenase(LDH)in serum and the effect of neoadjuvant chemotherapy(NACT)in patients with locally advanced pancreatic cancer(LAPC).Methods A retrospective analysis was conducted on the clinical data of 64 LAPC patients admitted to the hospital from August 2020 to August 2023.All patients underwent NACT(AG regimen:albumin bound paclitaxel combined with gemcitabine)for two consecutive cycles.The efficacy was evaluated according to the World Health Organization's solid tumor efficacy evaluation criteria(RECIST)and the patients were divided into an effective group(34 cases)and an ineffective group(30 cases).The expression of serum REG4 and LDH after NACT was compared between the two groups.The relationship between the expression of serum REG4 and LDH and the clinicopathological characteristics,NACT effect and survival time of LAPC patients were analyzed.Results The expression of serum REG4 and LDH in the effective group after 2 cycles of NACT was lower than that in the ineffective group(P<0.05).The effectiveness of NACT was related to the diameter,degree of differentiation,and lymph node metastasis of the patient's tumor(P<0.05).ROC curves was drawn,and the AUC for serum REG4,LDH,and combined prediction of NACT effect were>0.7,respectively,all of which had certain predictive value,and the combined predictive value was higher.Comparison of survival time between the high expression group of REG4 and the low expression group(P<0.05).The survival time of the LDH high expression group was compared with that of the low expression group(P<0.05).Conclusion The increased expression of serum REG4 and LDH is related to the effectiveness of NACT in LAPC patients and has certain predictive value.Early detection of serum REG4 and LDH levels in LAPC patients has a positive significance in ensuring NACT effectiveness.

关 键 词：局部进展期胰腺癌 新辅助化疗 血清人再生基因蛋白Ⅳ 血清乳酸脱氢酶 

分 类 号：R735[医药卫生—肿瘤]