| 仲思恂,郑良凤,鲁小敏.硫氧还蛋白还原酶活性检测在食管癌 60例临床诊断中的应用[J].安徽医药,2024,28(3):560-564. |
| 硫氧还蛋白还原酶活性检测在食管癌 60例临床诊断中的应用 |
| Application of TR activity detection in clinical diagnosis of 60 cases of esophageal cancer |
| |
| DOI：10.3969/j.issn.1009-6469.2024.03.029 |
| 中文关键词: 硫氧还蛋白还原酶 食管肿瘤 预后 肿瘤标志物 生存率 |
| 英文关键词: Thioredoxin reductase Esophageal neoplasms Prognosis Tumor markers Survival rate |
| 基金项目:南通市卫健委科研项目( QB2019012) |
|
| 摘要点击次数: 170 |
| 全文下载次数: 127 |
| 中文摘要: |
| 目的探究硫氧还蛋白还原酶( TR)活性检测在食管癌临床诊断中的应用。方法 2019年 1月至 2020年 7月海安市人民医院收治的食管癌病人、食管良性病灶病人及同期于该院进行体检的健康者，即分为食管癌组、良性组和对照组，各 60例。分别检测食管癌组、良性组和对照组病人血浆中 TR活性；检测食管癌组织病人化疗前、化疗时和化疗后血浆中 TR活性；比较食管癌组病人 TR活性在不同分期、转移方面的差异；评估食管癌组病人手术预后，随访 2年评估远期预后情况；确定 TR活性检测对食管癌病人的诊断价值。结果与对照组( 3.16±0.79)U/mL相比，良性组( 6.34±0.96)U/mL和食管癌组( 8.12±1.25)U/ mL病人血浆中 TR活性均明显升高( P<0.05)；且食管癌病人血浆中 TR活性明显高于良性组( P<0.05)。与化疗前( 8.12±1.25) U/mL相比，化疗时( 4.65±0.87)U/mL和化疗后( 3.37±0.62)U/mL食管癌病人血浆中 TR活性均明显降低( P<0.05)；且化疗后食管癌组病人血浆中 TR活性明显低于化疗时( P<0.05)。 TR活性表达和食管癌病人性别、年龄、肿瘤长径和肿瘤位置均无相关性(P>0.05)与病人淋巴结转移和 TNM分期密切相关( P<0.05)。和 Ⅰ＆Ⅱ期食管癌病人相比， Ⅲ&Ⅳ期食管癌病人血浆中 TR活性明显升高(，P<0.05)；和未转移食管癌病人相比，食管癌转移病人血浆中 TR活性明显升高( P<0.05)。食管癌病人化疗后有 39例病人得到了完全或部分缓解，病人总有效率为 65%。对食管癌病人随访 2年统计显示，食管癌病人 2年生存率为 75.0%(45例)TR高表达( >4 U/mL)2年生存人数为 31(31/41)例，生存率为 75.6%；TR低表达( <4 U/mL)2年生存率为 14(14/19)例，生存率为7，3.7%；log-rank检验 TR高表达和低表达病人生存率比较差异有统计学意义( P<0.05)。受试者操作特征曲线( ROC曲线)分析 TR检测曲线下面积( AUC)值为 0.92，特异度为 83.2%，灵敏度为 93.6%。结论 TR高表达于食管癌病人血浆中，其可用于食管癌的早期检测，提示病情的进展情况，对病人的治疗预后能有效评价。 |
| 英文摘要: |
| Objective To explore the application of thioredoxin reductase (TR) activity detection in the clinical diagnosis of esopha. geal cancer.Methods Patients with esophageal cancer and patients with benign esophageal lesions admitted to Hai'an People's Hos.pital from January 2019 to July 2020 and healthy subjects who underwent physical examination at the hospital during the same periodwere assigned into the esophageal cancer group, the benign group and the control group, with 60 cases in each. The TR activity in theplasma of patients with esophageal cancer group, benign group and control group was detected respectively; the TR activity in the plas.ma of patients with esophageal cancer tissue before chemotherapy, during chemotherapy and after chemotherapy was detected. The dif.ferences in TR activity among patients with esophageal cancer in different stages and metastases were compare; the surgical prognosisof patients in the esophageal cancer group was evaluated, and the long-term prognosis with a 2-year follow-up was evaluated; the diag. nostic value of TR activity detection for esophageal cancer patients was determined.Results Compared with the control group (3.16±0.79) U/mL, the TR activity in the plasma of patients in the benign group (6.34±0.96) U/mL and the esophageal cancer group (8.12±1.25) U/mL was significantly increased (P<0.05); and the TR activity in the plasma of esophageal cancer patients was significantly high. er than that of the benign group (P<0.05). Compared with before chemotherapy (8.12±1.25) U/mL, TR activity in the plasma of esopha.geal cancer patients during chemotherapy (4.65±0.87) U/mL and after chemotherapy (3.37±0.62) U/mL was significantly reduced (P< 0.05); and the TR activity in the plasma of patients with esophageal cancer after chemotherapy was significantly lower than that duringchemotherapy (P<0.05). There was no correlation between TR activity expression and gender, age, tumor diameter and tumor locationin patients with esophageal cancer (P>0.05), which was closely associated with lymph node metastasis and TNM stage (P<0.05). Com.pared with patients with stage Ⅰ & Ⅱ esophageal cancer, TR activity in the plasma of patients with stage Ⅲ & Ⅳ esophageal cancerwas significantly increased (P<0.05); compared with patients with non-metastatic esophageal cancer, TR activity in the plasma of pa. tients with esophageal cancer metastasis was significantly increased (P<0.05). After chemotherapy, 39 patients with esophageal cancerachieved complete or partial remission, and the overall effective rate was 65%. Statistics on the 2-year follow-up of esophageal cancer patients showed that the 2-year survival rate of esophageal cancer patients was 75.0% (45 cases). The number of 2-year survivors withhigh TR expression (>4 U/mL) was 31 (31/41) cases, and the survival rate was 75.6%; TR low expression (<4 U/mL) of the 2-year sur. vival rate was 14 (14/19) cases, and the survival rate was 73.7%; the log-rank test showed a statistically significant difference in surviv.al rates between patients with high TR expression and low TR expression (P<0.05). ROC curve analysis TR detection AUC value was 0.92, specificity was 83.2%, and sensitivity was 93.6%.Conclusion TR is highly expressed in the plasma of esophageal cancer pa.tients, which can be used for early detection of esophageal cancer, indicating the progression of the disease, and can effectively evaluatethe patient's treatment prognosis. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
