| 孙东跃,王旭青.胃癌根治术病人术前血清 sTWEAK、YKL-40水平对预后的影响[J].安徽医药,2025,29(4):729-732. |
| 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 |
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| DOI：10.3969/j.issn.1009-6469.2025.04.019 |
| 中文关键词: 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 |
| 英文关键词: Stomach neoplasms Gastrectomy TNF-like weak inducer of apoptosis Chitinase protein 40(YKL-40) Prognosis |
| 基金项目:江苏省老年健康科研项目( LKZ2023012) |
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| 中文摘要: |
| 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。 |
| 英文摘要: |
| Objective To investigate the expression levels of serum soluble tumor necrosis factor-like weak inducer of apoptosis (sT. WEAK) and chitinase protein 40 (YKL-40) in patients with GC undergoing radical surgery before operation, and their impact on progno. sis.Methods A total of 122 gastric cancer (GC) patients who underwent radical gastrectomy in Affiliated Hospital of Jiangsu Universi.ty from October 2017 to December 2019 were collected as the study subjects (GC group), and collect clinical data of patients were col.lected. Enzyme linked immunosorbent assay (ELISA) was applied to detect the serum levels of sTWEAK and YKL-40 in GC patientsbefore and after surgery. Patients with GC were followed up for 3 years after surgery, and the patients were divided into the group withgood 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 factorsin 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 TNMstage and histological type between the good prognosis group and the poor prognosis group (P<0.05).TNM stage, histological type, se. rum 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%, specific.ities of 36.2% and 36.9%, respectively, and the AUC of the two joint evaluation was 0.86, sensitivity and specificity were 80.0% and60.6%, respectively.Conclusions After radical GC resection, serum sTWEAK and YKL-40 levels were significantly reduced, and se. rum sTWEAK and YKL-40 were important factors affecting the prognosis of GC patients. Therefore, the expression levels of sTWEAK and YKL-40 in the serum of GC patients can predict the survival status of patients. |
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