结直肠癌手术前后尿液中卟啉代谢物变化及其与预后的关系

Changes of urinary porphyrin metabolites before and after operation for colorectal cancer and their correlation with prognosis

目的探讨结直肠癌患者手术前后尿液中卟啉代谢物变化及其与预后的关系。方法收集2016年6—12月河北北方学院附属第一医院100例结直肠癌患者,于术前、术后1周、术后1年及复发前留取尿液。用高效液相色谱法检测尿液中卟啉代谢产物尿卟啉原(UP)Ⅰ和粪卟啉原(CP)Ⅲ的含量,分析结直肠癌患者手术前后尿液中UPⅠ和CPⅢ的水平变化及与其临床病理特征的关系,分析其含量变化与术后复发、转移的关系。结果结直肠癌患者术后尿液中UPⅠ和CPⅢ水平显著低于术前[(66.80±17.62)μmol/g比(35.58±9.32)μmol/g、(20.14±3.14)μmol/g比(10.38±0.85)μmol/g],差异有统计学意义(t=26.788、25.712,P<0.05)。Dukes分期C/D期患者UPⅠ和CPⅢ水平均明显高于A/B期[(45.26±5.26)μmol/g比(28.56±3.45)μmol/g、(86.57±6.58)μmol/g比(52.48±3.36)μmol/g],有淋巴结转移患者UPⅠ和CPⅢ水平均明显高于无淋巴结转移患者[(45.44±5.46)μmol/g比(30.27±6.07)μmol/g、(86.67±6.87)μmol/g比(56.10±11.08)μmol/g],差异均有统计学意义(P<0.05)。尿液中UPⅠ和CPⅢ水平是结直肠癌患者术后复发、转移的独立危险因素(OR=1.149、1.065,P<0.05)。结论尿液卟啉代谢物(UPⅠ和CPⅢ)可能是一种有效评估结直肠癌患者的新型肿瘤标志物。

Objective To investigate the changes of porphyrin metabolites in urine of patients with colorectal cancer before and after operation and their correlation with prognosis.Methods One hundred patients with colorectal cancer were collected in First Affiliated Hospital of Hebei North University from June 2016 to December 2016,urine was collected before operation,1 week after operation,1 year after operation and before recurrence.The contents of urinary porphyrin metabolites of uroporphyrinogenI(UPⅠ)and coproporphyrinogenⅢ(CPⅢ)were detected by high performance liquid chromatography.Toanalyse the changes of UPⅠand CPⅢlevels before and after operaction of colorectal cancer and their correlation with clinicopathologicalcharacteristics,and the recurrence and metastasis after operation.Results The levels of UPⅠand CPⅢin urine of patients with colorectal cancer after operation were significantly lower than those before operation[(66.80±17.62)μmol/g vs.(35.58±9.32)μmol/g,(20.14±3.14)μmol/g vs.(10.38±0.85)μmol/g](P<0.05).The levels of UPⅠand CPⅢin urine of patients with Dukes C/D stage were significantly higher than those with Dukes A/B stage[(45.26±5.26)μmol/g vs.(28.56±3.45)μmol/g,(86.57±6.58)μmol/g vs.(52.48±3.36)μmol/g],the levels of UPⅠand CPⅢin urine of patients with lymph node metastasis were significantly higher than those without lymph node metastasis[(45.44±5.46)μmol/g vs.(30.27±6.07)μmol/g,(86.67±6.87)μmol/g vs.(56.10±11.08)μmol/g],there were significant differences(P<0.05).Urinary levels of UPⅠand CPⅢwere independent risk factors for recurrence and metastasis of colorectal cancer after operation(OR=1.149 and 1.065,P<0.05).Conclusions Porphyrin metabolites(UPⅠand CPⅢ)in urine may serve as a new marker for assessing colorectal cancer.