胃癌手术前后血清肝细胞生长因子动态变化及其与肝转移的关系

Dynamic changes of serum hepatocyte growth factor in patients with gastric cancer before and after operation and its relationship with liver metastasis

目的 探讨胃癌手术前后血清肝细胞生长因子（HGF）动态变化及其与肝转移的关系.方法 回顾性分析2014年10月-2016年3月于温州医科大学附属第一医院行手术治疗的120例原发性胃癌患者临床资料,记录其手术前后血清HGF水平差异;分析不同临床分期、有无淋巴结转移、有无肝转移患者手术后血清HGF水平差异,经Spearman相关系数分析原发性胃癌患者术后血清HGF水平同肝转移、淋巴结转移及TNM分期的关系.结果 行根治性手术及姑息性手术的112例患者,术后血清HGF水平均较术前明显降低[（2.05±1.18）μg/L vs（2.86±1.22）μg/L,P〈0.05],行腹部探查手术的8例患者术后血清HGF水平则较术前无明显变化（P〉0.05）;TNM分期为 Ⅲ-Ⅳ期者血清HGF水平明显高于TNM分期为Ⅰ-Ⅱ期者[（4.37±2.84）μg/L vs（2.48±1.46）μg/L,P〈0.05],淋巴结转移者血清HGF水平明显高于无淋巴结转移者[（3.72±2.14）μg/L vs（2.18±1.15）μg/L,P〈0.05],肝转移者血清HGF水平明显高于无肝转移者[（5.33±3.41）μg/L vs（2.26±1.37）μg/L,P〈0.05];胃癌手术患者术后血清HGF水平同肝转移、淋巴结转移及TNM分期均呈正相关（r=0.503,0.599,0.601,P均=0.000）.结论 血清HGF水平同胃癌患者肝转移、淋巴结转移及TNM分期均呈正相关,临床可将其作为反映患者病情严重程度及预测其预后情况的辅助指标,胃癌根治性手术及姑息性手术均能有效调节血清HGF水平,对患者预后有利.

Objective To investigate the dynamic changes of serum hepatocyte growth factor （HGF）in patients with gastric cancer before and after operation and its relationship with liver metastasis. Methods The clinical data of 120 patients with primary gastric cancer,who underwent operation in the First Alfiliated Hospital of Wenzhou Medical University between October 2014 and March 2016,were retrospectively analyzed. The differences in serum HGF levels before and after the operation were recorded. The postoperative serum HGF levels were compared between patients in different clinical stages,with/without lymph node metastasis,and with/without liver metastasis. The relationship between postoperative serum HGF levels and liver metastasis,lymph node metastasis and TNM stage was analyzed by Spearman correlation coefficient analysis. Results The serum HGF levels in 112 patients after radical operation and palliative operation were significantly lower than those before operation[（2.05±1.18）μg/L vs（2.86±1.22）μg/L]（P〈0.05） while there was no significant change of serum HGF levels in patients who underwent abdominal probing （P〉0.05）. The serum HGF levels in patients at TNM stage Ⅲ - Ⅳ were significantly higher than those in TNM stageⅠ-Ⅱ[（4.37 ± 2.84）μg/L vs（2.48 ± 1.46）μg/L],the levels in patients with lymph node metastasis were significantly higher than those without lymph node metastasis[（3.72±2.14）μg/L vs（2.18 ± 1.15）μg/L],and the serum HGF levels in patients with liver metastasis were significantly higher than those without[（5.33 ± 3.41）μg/L vs（2.26 ± 1.37）μg/L]（P〈0.05）. The postoperative serum HGF levels in patients with gastric cancer were positively correlated with liver metastasis,lymph node metastasis and TNM stage （r=0.503,0.599,0.601,all P=0.000）. Conclusion The serum HGF levels in patients with gastric cancer are positively correlated with liver metastasis,lymph node metastasis and TNM stage,which can be used as the auxiliary index for reflecting the severity of disease and predicting the prognosis. Radical operation and palliative operation of gastric cancer can effectively regulate the serum HGF levels in patients , which favor the prognosis of patients.