膀胱癌100例血清Zeste基因增强子同源物2和信号传导蛋白3表达水平及诊断价值分析

Expression and diagnostic value analysis of enhancer of zeste homolog 2 and signal transduction protein 3 in 100 cases of bladder cancer

目的探讨膀胱癌病人血清Zeste基因增强子同源物2(EZH2)和信号传导蛋白3(SMAD3)表达水平及临床意义。方法纳入江苏省人民医院宿迁医院于2021年1月至2022年12月收治的膀胱癌病人进行研究(100例),另选取同期于该院就诊的泌尿系统良性疾病病人作为良性疾病组(93例)以及健康体检者作为对照(100例)。采用Pearson相关性分析法分析膀胱癌病人血清中EZH2和SMAD3表达水平的相关性;采用logistic多因素回归分析法分析膀胱癌发生的影响因素;采用ROC曲线分析EZH2和SMAD3对膀胱癌的诊断效能。结果膀胱癌病人血清中EZH2(101.34±15.09)ng/L和SMAD3(226.53±25.94)ng/L表达水平均高于良性疾病组(85.96±11.23)ng/L、(203.11±22.18)ng/L和对照组(83.91±9.14)ng/L、(198.03±20.30)ng/L(均P<0.001);膀胱癌病人血清EZH2和SMAD3表达水平呈正相关(r=0.72,P<0.001);膀胱癌组年龄≥60岁(74/187)、有吸烟史的病人(76/166)所占比例均高于良性疾病组(65/187、55/166)及对照组(48/187、35/166)(均P<0.05);年龄、吸烟史、EZH2、SMAD3为发生膀胱癌的危险因素(P<0.05);以良性疾病组为对照,血清EZH2和SMAD3单独检测诊断膀胱癌的曲线下面积(AUC)分别为0.78、0.78,二者联合检测的AUC为0.85,优于各自单独检测(Z_(二者联合-EZH2)=2.81、Z_(二者联合-SMAD3)=2.68,P=0.009、0.007)。结论血清EZH2和SMAD3与膀胱癌的发生有关,二者联合对膀胱癌具有一定的诊断价值。

Objective To investigate the expression levels of enhancer of Zeste homolog 2(EZH2)and signal transduction protein 3(SMAD3)in serum of patients with bladder cancer and their clinical significance.Methods The study included 100 patients with bladder cancer admitted to Jiangsu Provincial People's Hospital Suqian Hospital from January 2021 to December 2022.In addition,patients with benign diseases of the urinary system who visited our hospital at the same time were selected as the benign disease group(93 cases)and health check-up participants as controls(100 cases).Pearson correlation analysis was used to analyze the correlation between the expression levels of EZH2 and SMAD3 in the serum of bladder cancer patients;Logistic regression analysis was used to analyze the influencing factors of bladder cancer;ROC curve was used to analyze the diagnostic efficacy of EZH2 and SMAD3 in bladder cancer.Results The expression levels of EZH2(101.34±15.09)ng/L and SMAD3(226.53±25.94)ng/L in the bladder cancer group were significantly higher than those in the benign disease group(85.96±11.23)ng/L,(203.11±22.18)ng/L and the control group(83.91±9.14)ng/L,(198.03±20.30)ng/L(P<0.001);the expression levels of EZH2 and SMAD3 in serum of bladder cancer patients were positively correlated(r=0.72,P<0.001);the proportions of patients with age≥60 years(74/187)and smoking history(76/166)in bladder cancer group were higher than those in benign disease group(65/187,55/166)and control group(48/187,35/166)(P<0.05);age,smoking history,EZH2,and SMAD3 were risk factors for bladder cancer(P<0.05);Using the benign disease group as a control,the AUC of serum EZH2 and SMAD3 for diagnosis of bladder cancer was 0.78 and 0.78,respectively,and the AUC of the combination of the two was 0.85,which was superior to individual testing(Z_(combined detection-EZH2)=2.81,Z_(combined detection-SMAD3)=2.68,P=0.009,0.007).Conclusion Serum EZH2 and SMAD3 are related to the occurrence of bladder cancer,and their combination has certain diagnostic value for bladder cancer.