论文部分内容阅读
目的检测胃腺癌患者血清中基质细胞衍生因子-1α(SDF-1α)含量及探讨其临床意义。方法应用酶联免疫吸附法检测胃腺癌患者血清中SDF-1α含量,分析其与胃腺癌患者临床病理特征及预后的关系。结果1胃腺癌患者血清SDF-1α含量〔n=90,(6 950.8±1 131.3)ng/L〕明显高于健康自愿者〔n=25,(5 023.7±1 103.8)ng/L〕,差异有统计学意义(P=0.036)。2发生远处转移的胃腺癌患者(n=12)血清SDF-1α含量〔(8 251.6±1 042.5)ng/L〕明显高于未发生远处转移患者〔n=78,(6 785.3±1 025.0)ng/L〕,差异有统计学意义(P<0.001)。发生肝转移(P=0.002)和肺转移(P=0.030)的患者外周血中SDF-1α含量也均分别明显高于相应未发生转移的患者。3胃腺癌患者肿瘤TNM分期较晚(P<0.001)、淋巴结转移更为广泛(P=0.018)、肿瘤浸润较深(P<0.001)、存在血管侵犯(P<0.001)及淋巴管侵犯(P<0.001)的胃腺癌患者的血清中SDF-1α含量明显升高。logistic回归分析结果提示,肿瘤浸润深度(OR=14.999,95%可信区间为3.568~74.456,P=0.027)和有远处转移(OR=0.186,95%可信区间为0.610~2.014,P=0.026)与胃腺癌患者血清中SDF-1α含量升高有关。4外周血中SDF-1α高表达患者的术后生存时间明显短于SDF-1α低表达患者(P<0.001)。Cox比例风险回归模型分析提示肿瘤分期(RR=2.497,95%可信区间为1.987~10.238,P=0.009)、血管侵犯程度(RR=7.501,95%可信区间为2.086~16.942,P=0.002)及外周血中SDF-1α含量(RR=18.302,95%可信区间为6.895~30.538,P=0.001)是影响胃腺癌患者预后的独立危险因素。结论胃腺癌患者外周血中SDF-1α的升高或提示淋巴结、肝及肺转移可能,并预示胃腺癌患者预后较差。
Objective To detect the serum levels of stromal cell derived factor-1α (SDF-1α) in patients with gastric adenocarcinoma and to explore its clinical significance. Methods Serum levels of SDF-1α in patients with gastric adenocarcinoma were detected by enzyme-linked immunosorbent assay (ELISA), and their relationship with clinicopathological features and prognosis of patients with gastric adenocarcinoma was analyzed. Results The serum level of SDF-1α in patients with gastric adenocarcinoma [n = 90 (6 950.8 ± 1 131.3) ng / L] was significantly higher than that in healthy volunteers (n = 25, (5202.7 ± 1 103.8) ng / L) There was statistical significance (P = 0.036). 2 Serum levels of SDF-1α in patients with distant metastasis of gastric adenocarcinoma (n = 12) [(8 251.6 ± 1 042.5) ng / L] were significantly higher than those in patients without distant metastases 〔n = 78, (6785.3 ± 1 025.0) ng / L], the difference was statistically significant (P <0.001). The levels of SDF-1α in peripheral blood of patients with liver metastases (P = 0.002) and lung metastases (P = 0.030) were also significantly higher than those without corresponding metastases. TNM staging of gastric adenocarcinoma was delayed (P <0.001), lymph node metastasis was more extensive (P = 0.018), tumor infiltration was deeper (P <0.001), and there was vascular invasion (P <0.001) and lymphatic invasion <0.001) in patients with gastric adenocarcinoma serum SDF-1α content was significantly increased. Logistic regression analysis showed that the depth of tumor invasion (OR = 14.999, 95% CI 3.568-74.456, P = 0.027) and distant metastasis (OR = 0.186, 95% CI 0.610-2.014, P = 0.026) was related to the increase of serum SDF-1α in patients with gastric adenocarcinoma. The survival time of SDF-1α-overexpressing patients in peripheral blood was significantly shorter than that in patients with low expression of SDF-1α (P <0.001). Cox proportional hazards regression analysis suggested that the tumor stage (RR = 2.497, 95% confidence interval 1.987-10.238, P = 0.009), vascular invasion (RR = 7.501, 95% confidence interval 2.086-16.942, P = 0.002 ) And SDF-1α in peripheral blood (RR = 18.302, 95% confidence interval 6.895-30.538, P = 0.001) were independent risk factors for the prognosis of patients with gastric adenocarcinoma. Conclusions The increase of SDF-1α in peripheral blood of patients with gastric adenocarcinoma may indicate the possibility of lymph node, liver and lung metastasis and indicate the poor prognosis of patients with gastric adenocarcinoma.