外周血D-D及TGF-β1和叶酸水平在食管癌手术前后变化及与预后的相关性研究

Changes of peripheral blood D-D,TGF-β1 and folic acid levels in esophageal carcinoma patients before and after operation and their correlation with prognosis

目的考察外周血D-二聚体(D-dimer,D-D)、转化生长因子-β1(transforming growth factor-beta 1,TGF-β1)和叶酸水平在食管癌患者手术前后的变化及其与食管癌预后的相关性。方法收集2012年6月至2013年6月112例南阳市中心医院确诊为食管癌的患者为研究对象。选择同期健康体检者53例为对照组。结果与对照组比,食管癌组手术前的D-D和TGF-β1明显增高(P<0.05),叶酸明显降低(P<0.05),食管癌组手术后的D-D和TGF-β1明显降低(P<0.05),叶酸明显增高(P<0.05),食管癌组手术后的D-D和TGF-β1与对照组无统计学意义(P>0.05)。手术前D-D、TGF-β1和叶酸与性别、年龄和病变部位无相关性(P>0.05),与病理类型、侵润深度、淋巴结是否转移、肿瘤大小及TNM分期存在相关性(P<0.05)。112例食管癌患者术后5年,存活39例,生存率为34.82(39/112),50%的生存时间为45个月。手术前D-D(r=-0.58,P=0.034)、TGF-β1(r=-0.75,P=0.002)和叶酸(r=0.67,P=0.012)与5年生存存在相关性,手术后D-D、TGF-β1和叶酸(r=0.12,P=0.701)与5年生存无相关性(P>0.05)。结论食管癌手术可明显改善患者外周血D-D、TGF-β1和叶酸水平,术前外周血D-D、TGF-β1和叶酸水平与食管癌患者预后密切相关。

Objective To investigate the changes of D-dimer(D-D),transforming growth factor-beta 1(TGF-β1)and folic acid in esophageal carcinoma patients before and after operation and their correlation with the prognosis.Methods A total of 112 patients diagnosed with esophageal cancer from June 2012 to June 2013 were enrolled in this study.53 healthy controls were selected as controls.Results Compared with the control group,D-D and TGF-β1 had significantly increased(P<0.05),folic acid had decreased significantly(P<0.05)in esophageal cancer group,before operation.D-D and TGF-β1 had significantly decreased(P<0.05),folic acid had increased significantly(P<0.05)in esophageal cancer group,after operation.The D-D,TGF-β1 and folic acid were comparable in esophageal cancer group after operation and the control group(P>0.05).There had no correlation between D-D,TGF-β1 and folic acid with sex,age and lesion location(P>0.05).There had a correlation between D-D,TGF-β1 and folic acid with the pathological type,depth of invasion,lymph node metastasis,tumor size and TNM staging(P<0.05).In 112 esophageal cancer patients,39 cases survived after 5 years,with the survival rate was of 34.82(39/112),50%of the survival time of 45 months.Before operation,D-D(r=-0.58,P=0.034),TGF-β1(r=-0.75,P=0.002)and folic acid(r=0.67,P=0.012)were associated with 5-year survival.After operation,D-D,TGF-β1 and folic acid were not associated with 5-year survival(P>0.05).Conclusion Operation can improve the D-D,TGF-β1 and folic acid in peripheral blood of esophageal carcinoma.The levels of D-D,TGF-β1 and folic acid in peripheral blood before operation are closely related to the prognosis of cancer patients with esophagel carcinoma.