血清TK1、ULBP2水平预测转移性结直肠癌患者化疗效果的临床研究

Clinical Study of Serum TK1 and ULBP2 Levels in Predicting the Effect of Chemotherapy in Patients with Metastatic Colorectal Cancer

目的观察血清胸苷激酶1(TK1)、UL16结合蛋白2(ULBP2)在转移性结直肠癌(CRC)患者中的表达,并分析各指标预测患者化疗无效风险的价值。方法选取81例转移性CRC患者为研究对象,患者均完成4个化疗周期。化疗结束时,评价化疗效果并分组。分别于患者入院时、化疗结束时检测血清TK1、ULBP2水平,分析血清TK1、ULBP2水平预测转移性CRC患者化疗无效风险的价值。结果81例患者化疗结束时血清ULBP2、TK1水平均较入院时降低(P<0.05)。81例转移性CRC患者经4个周期化疗后,临床缓解53例(65.43%),无效28例(34.57%)。无效组血清ULBP2、TK1水平高于缓解组(P<0.05);经二元Logistic回归分析后建立多元回归模型,结果显示,血清ULBP2、TK1过表达是患者化疗无效的影响因素(OR>1,P<0.05)。绘制ROC曲线,血清ULBP2、TK1单独及联合预测患者化疗无效的AUC均>0.80,且当二者的cut-off值分别取79.90 ng/l、5.145 pmol/l时,可获得最佳预测价值。结论血清ULBP2、TK1过表达可能提示转移性CRC患者化疗无效风险,临床可考虑在转移性结直肠癌患者化疗前检测患者血清ULBP2、TK1水平,指导早期干预计划的拟定,可能对提高化疗整体获益、促进患者良性预后意义重大。

Objective To observe the expression of serum thymidine kinase 1(TK1)and UL16 binding protein 2(ULBP2)in patients with metastatic colorectal cancer(CRC),and to analyze the value of each index in predicting the risk of ineffective chemotherapy.Methods 81 patients with metastatic CRC were selected.All patients completed 4 cycles of chemotherapy;at the end of chemotherapy,evaluated the effect of chemotherapy and divided them into groups;detected serum TK1 and ULBP2 levels when the patients were admitted to the hospital and at the end of chemotherapy;analyzed the value of serum TK1 and ULBP2 levels in predicting the risk of chemotherapy ineffectiveness in patients with metastatic CRC.Results The serum ULBP2 and TK1 levels of 81 patients at the end of chemotherapy were lower than those at admission(P<0.05);the evaluation of 81 patients with metastatic CRC after 4 cycles of chemotherapy found that 53 cases were clinical remission,accounting for 65.43%,and 28 cases were ineffective,accounting for 34.57%.The serum ULBP2 and TK1 levels of the invalid group were higher than those of the remission group(P<0.05);after binary logistic regression analysis,a multiple regression model was established.The results showed that the overexpression of serum ULBP2 and TK1 was the influencing factor of patients with chemotherapy ineffectiveness(OR>1,P<0.05);the ROC curve was drawn,the serum ULBP2 and TK1 alone and in combination predicted the AUC of patients with chemotherapy ineffectiveness were>0.80,and when the cut-off values of them were 79.90 ng/l and 5.145 pmol/l,the best predictive value could be obtained.Conclusion The overexpression of serum ULBP2 and TK1 may indicate the risk of chemotherapy ineffectiveness in patients with metastatic CRC.Clinically,it can be considered to detect the serum ULBP2 and TK1 levels of patients with metastatic colorectal cancer before chemotherapy,in order to predict the risk of chemotherapy ineffectiveness in CRC patients and guide the formulation of early intervention plans,which may be of great significance to improve the overall benefit of chemotherapy and promote the benign prognosis of patients.