硫氧还蛋白还原酶表达与晚期结直肠癌近期疗效和疾病进展的相关性

Correlation between the expression of thioredoxin reductase and the short-term efficacy and disease progression of advanced colorectal cancer

目的:回顾性分析硫氧还蛋白还原酶(thioredoxin reductase,TrxR)与晚期结直肠癌近期疗效和无进展生存期的关联,探讨该指标对晚期结直肠癌患者治疗效果和病情控制的评估作用。方法:纳入108例晚期结直肠癌患者,检测患者的外周血TrxR表达水平,2周期化疗结束后复测外周血TrxR表达水平,并采取实体瘤疗效评价标准1.1版对其化疗效果进行评价,探寻治疗前后TrxR表达波动情况与近期治疗效果之间的关联。治疗前TrxR均数为8.6856 U/mL。以该值作为截断值,将入组病例分为TrxR高表达组和低表达组,通过K aplan-Me ie r法和C OX回归来探讨TrxR表达水平与患者无进展生存期的相关性。结果:在经过2个周期的治疗后,出现部分缓解的患者治疗后TrxR表达水平较治疗前下降,差异有统计学意义(P=0.001)。Kaplan-Meier分析显示治疗前TrxR低表达的患者较治疗前TrxR高表达的患者无进展生存期更长,差异有统计学意义(P=0.023)。COX单因素分析显示治疗前TrxR表达水平是晚期结直肠癌发生病情进展的独立风险因素(P=0.019)。COX多因素分析也提示了相同的结果(P=0.022)。结论:TrxR的表达水平和晚期结直肠癌患者治疗疗效和疾病进展之间具有密切的关系。

Objective:To investigate the relationship between the level of thioredoxin reductase(Trx R)and the short-term efficacy and progression-free survival(PFS)of advanced colorectal cancer,and explore the potential value of Trx R on the efficacy evaluation and disease control in advanced colorectal cancer.Methods:A total of 108 patients with advanced colorectal cancer were included.The level of Trx R in the peripheral blood of the patients was detected.After 2 cycles of chemotherapy,the level of Trx R in the peripheral blood was detected again.Response Evaluation Criteria in Solid Tumors(1.1 version)was used to evaluate the treatment effect.The Trx R value fluctuated before and after treatment.So,the relationship between the fluctuation and the treatment efficacy was explored.The mean value of Trx R before treatment was 8.6856 U/m L.This value was used as the cutoff value to divide the enrolled cases into high expression group and low expression group.Kaplan-Meier method and COX regression were used to explore the correlation between Trx R expression level and PFS.Results:After two cycles of chemotherapy,the Trx R level of patients with partial response decreased after treatment compared with before treatment,and the difference was statistically significant(P=0.001).Kaplan-Meier analysis showed that patients with low Trx R expression before treatment had longer PFS than those with high Trx R expression before treatment,and the difference was statistically significant(P=0.023).COX univariate analysis showed that Trx R expression level before treatment was an independent risk factor for the progression of advanced colorectal cancer(P=0.019).COX multivariate analysis also suggested the same result(P=0.022).Conclusion:There is a close relationship between the expression level of Trx R and the short-term efficacy and disease progression of patients with advanced colorectal cancer.