血清MMP-9、PCT水平与结直肠癌患者腹腔镜根治术后吻合口瘘的关系研究

Study on the relationship between serum MMP-9 and PCT levels and anastomotic fistula in patients with colorectal cancer after laparoscopic radical surgery

目的 观察结直肠癌患者术后发生吻合口瘘患者的血清降钙素原(PCT)、基质金属蛋白酶-9(MMP-9)表达,并分析上述血清指标与吻合口瘘发生的关系,旨在减少结直肠癌患者术后吻合口瘘发生率。方法 回顾性分析,采集本院2018年1月至2021年6月期间收治的50例结直肠癌患者术后发生吻合口瘘患者的基线资料,采集同时期内收治的50例结直肠癌患者的基线资料,对比两组患者血清PCT、MMP-9表达情况,分析血清PCT。MMP-9表达与结直肠癌患者腹腔镜根治术后吻合口瘘发生的关系研究。结果 与发生组患者相比,未发生组患者血清PCT、MMP-9呈高表达(P<0.05);两组间其他基线资料对比,差异无统计学意义(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PCT、MMP-9表达是影响结直肠癌患者腹腔镜根治术后吻合口瘘的风险因子(OR>1,P<0.05);经绘制ROC曲线图结果显示,血清PCT、MMP-9表达单独及联合预测结直肠癌患者腹腔镜根治术后吻合口瘘的AUC分别为0.876、0.920、0.922,均>0.8,预测价值理想。结论 血清PCT、MMP-9表达情况与结直肠癌患者腹腔镜根治术后吻合口瘘发生情况密切相关,临床可通过检查血清PCT、MMP-9表达情况来预测结直肠癌患者腹腔镜根治术后吻合口瘘发生风险。

Objective To observe the expression of serum calcitoninogen(PCT) and matrix metalloproteinase-9(MMP-9) in patients with colorectal cancer who developed anastomotic fistula after surgery, and to analyze the relationship between the above serum indicators and the occur-rence of anastomotic fistula, aiming to reduce the incidence of anastomotic fistula after surgery in patients with colorectal cancer. Methods Retrospective analysis was performed to collect baseline data of 50 patients with postoperative anastomotic fistula in colorectal cancer patients admitted to our hospital between January 2018 and June 2021, and baseline data of 50 colorectal cancer patients admitted during the same period were collected to compare the expression of serum PCT and MMP-9 in the two groups and analyze the relationship between serum PCT, expression of MMP-9 and laparoscopic anastomotic fistula in colorectal cancer patients. The relationship between MMP-9 expression and the occurrence of anastomotic fistula after radical resection was studied. Results Compared with patients in the occurrence group, patients in the non-occurrence group showed high ex-pression of serum PCT and MMP-9(P<0.05). Other baseline data between the two groups were compared, and the differences were not statistically significant(P>0.05). After binary logistic regression analysis, a multiple regression model was established, and the results showed that serum PCT and MMP-9 expression were the risk factors affecting colorectal cancer patients after laparoscopic radical surgery. The results showed that serum PCT and MMP-9 expression were risk factors affecting anastomotic fistula after laparoscopic radical surgery in colorectal cancer patients(OR >1, P<0.05). The results of ROC plot showed that the AUCs of serum PCT and MMP-9 expression alone and combined to predict anastomotic fistula after laparoscopic radical surgery in colorectal cancer patients were 0.876, 0.920 and 0.922, respectively, all of which were >0.8, with ideal predictive value. Conclusion The expression of serum PCT and MMP-9 is closely related to the occurrence of anastomotic fistula after laparoscopic radical surgery in col-orectal cancer patients, and the risk of anastomotic fistula after laparoscopic radical surgery in colorectal cancer patients can be predicted by checking the expression of serum PCT and MMP-9 in clinical practice.