血清MACC-1、Ang-2水平预测直肠癌患者腹腔镜术后复发研究

Study on serum MACC-1 and Ang-2 levels in predicting the recurrence of rectal cancer patients after laparoscopic surgery

目的观察血清结肠癌转移相关基因-1(MACC-1)、血管生成素-2(Ang-2)水平预测直肠癌患者腹腔镜全直肠系膜切除术(TME)后复发的效能。方法选取该院2016年11月至2019年11月收治的150例直肠癌患者作为研究对象,于术前检测患者血清MACC-1、Ang-2水平,实施TME治疗,指导患者定期到院复查,每3个月1次,记录患者12个月内复发情况,将患者分为复发组(31例)和未复发组(119例),比较两组基线资料水平,分析直肠癌患者肿瘤分期、肿瘤分化程度、淋巴结转移、癌胚抗原(CEA)、糖类抗原199(CA199)、术前血清MACC-1及Ang-2水平表达与术后复发的关系,分析血清MACC-1、Ang-2水平对患者复发风险的预测价值。结果150例直肠癌患者中,有23例复发,有8例复发及转移,总复发率为20.66%;基线资料比较后经回归分析结果显示,直肠癌患者Ⅳ期、低分化、合并淋巴结转移、CEA阳性、CA199阳性、术前血清MACC-1及Ang-2水平均与直肠癌术后复发有关,可能均是直肠癌术后复发的风险因子(OR>1,P<0.05);绘制受试者工作特征曲线发现,直肠癌患者术前血清MACC-1及Ang-2水平单项及联合检测预测术后复发的曲线下面积均>0.800,均有一定预测价值。结论直肠癌患者TME术后1年内复发风险高,术前血清MACC-1、Ang-2水平过表达均与TME术后复发有关,可将二者用于直肠癌术后复发风险的预测。

Objective To observe the efficacy of serum colon cancer metastasis-related gene-1(MACC-1)and angiopoietin-2(Ang-2)levels in predicting the recurrence of patients with rectal cancer after laparoscopic total mesorectal excision(TME).Methods A total of 150 patients with rectal cancer admitted to the hospital from November 2016 to November 2019 were selected as the research objects.Detected the patient′s serum MACC-1 and Ang-2 levels before surgery,conducted TME treatment,guided patients to go to the hospital for review regularly,once every 3 months,and recorded the recurrence of patients within 12 months,divided the patients into a relapse group(31 cases)and a non-relapse group(119 cases),and compared the baseline data levels of the two groups.Analyzed the relationship between tumor stage,tumor differentiation,lymph node metastasis,carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),preoperative serum MACC-1 and Ang-2 levels and postoperative recurrence in patients with rectal cancer.Analyzed the predictive value of serum MACC-1 and Ang-2 levels on the risk of recurrence in patients.Results Among the 150 patients with rectal cancer,there were 23 recurrences and 8 recurrences and metastases,the total recurrence rate was 20.66%.After compared baseline data,regression analysis results showed that rectal cancer patients with stageⅣ,poorly differentiated,combined with lymph node metastasis,CEA positive,CA199 positive,preoperative serum MACC-1 and Ang-2 levels were related to rectal cancer postoperative recurrence,might be risk factors for rectal cancer postoperative recurrence(OR>1,P<0.05).Plotted the receiver operating characteristic curve found that the area under the curve of single and combined detection of serum MACC-1 and Ang-2 levels in patients with rectal cancer to predict postoperative recurrence was>0.800,which had a certain predictive value.Conclusion Rectal cancer patients have a high risk of recurrence within 1 year after TME.The preoperative serum MACC-1 and Ang-2 levels are all related to recurrence after TME.Both could be used to predict the risk of recurrence after rectal cancer surgery.