IGF-1与LP在结直肠癌患者血清中的表达及临床意义

Expression and clinical significance of IGF-1 and LP in serum of colorectal cancer patients

目的检测胰岛素样生长因子(IGF-1)和瘦素(LP)在结直肠癌患者血清中的表达水平,并分析其临床意义。方法选取73例结直肠癌患者,37例结直肠癌良性病变患者及40例健康受试者,检测其血清IGF-1及LP水平。对结直肠患者进行为期2年的随访观察,观察其是否发生淋巴结转移。采用Logistic回归,分析影响结直肠癌患者淋巴结转移的因素。采用受试者工作特征曲线(ROC)下面积(AUC)分析IGF-1及LP用于结直肠癌及复发的诊断价值。结果结直肠癌血清IGF-1浓度明显低于对照组(P<0.05),但与良性病变患者的差异无统计学意义(P>0.05)。结直肠癌血清LP水平明显高于良性病变组及对照组(均P<0.05)。IGF-1与LP均对结直肠癌有一定的诊断价值,二者联合检测诊断效能高于分别单独检测(P<0.05)。结直肠癌患者2年复发率为16.43%,复发患者年龄(≥40岁)、TNM分级(Ⅲ~Ⅳ级)、肿瘤直径(≥4 cm)、存在血管浸润及深肌层浸润的分布比例明显高于未复发患者(均P<0.05);癌转移患者血清IGF-1水平明显低于未转移者(P<0.05),LP水平明显高于未转移者(P<0.05)。血管浸润、深肌层浸润、低IGF-1水平和高LP水平为结直肠癌患者复发的独立影响因素,其联合预测结直肠癌患者复发的AUC=0.956(95%CI:0.988 1~0.990)。结论在结直肠癌患者体内IGF-1呈低水平,LP呈高水平,两者与癌复发关系密切。

Objective To detect the expression levels of insulin-like growth factor 1 (IGF-1) and leptin (LP) in serum of patients with colorectal cancer, and to analyze its clinical significance. Methods Seventy-three patients with colorectal cancer, 37 patients with benign colorectal cancer and 40 healthy subjects were enrolled. Serum IGF-1 and LP levels of all the subjects were measured. A two-year follow-up study of colorectal patients was performed to observe the occurrence of lymph node metastasis. Logistic regression was used to analyze the factors affecting lymph node metastasis in colorectal cancer patients. The area under the receiver operating characteristic curve (AUC) was used to analyze the diagnostic value of IGF-1 and LP for colorectal cancer and recurrence. Results The serum IGF-1 concentration in colorectal cancer was significantly lower than that in the control group (P<0.05), but there was no significant difference between the patients with benign lesions (P>0.05). The serum LP level of colorectal cancer was significantly higher than that of benign lesions and control group (P<0.05). Both IGF-1 and LP have certain diagnostic value for colorectal cancer, and the combined test and efficacy of the two methods are higher than those of the separate test (P<0.05). The two-year recurrence rate of colorectal cancer patients was 16.43%, and the patient age (≥40 years old), TNM grade (Ⅲ~Ⅳ grade), tumor diameter (≥4 cm), vascular infiltration and deep muscle infiltration in the recurrent patients were significantly higher than that in the untreated patients (all P<0.05). In the cancer metastasis patients, the level of serum IGF-1 and LP was significantly lower and higher than that in non-metastatic patients, respectively (all P<0.05). Vascular infiltration, deep myometrial invasion, low IGF-1 levels, and high LP levels were independent predictors of recurrence in colorectal cancer patients, and the combined predictive AUC of the above four factors was 0.956 (95%CI: 0.988 1~0.990). Conclusions In patients with colorectal cancer, IGF-1 level is low and LP level is high, which is closely related to cancer recurrence.