GDF15、TK1在卵巢癌患者血清中的表达及与预后的Cox回归分析

Expression of GDF15 and TK1 in serum of patients with ovarian cancer and Cox regression analysis of prognosis

目的探索生长分化因子15(recombinant growth differentiation factor 15,GDF15)、胸苷激酶(thymidine kinase 1,TKI)在卵巢癌患者血清中的表达及与预后Cox回归相关性。方法前瞻性选取50例接受血清检测的健康体检者(对照组)、52例卵巢良性疾病组(良性组)、51例卵巢癌患者(卵巢癌组),均进行了血清GDF15、TK1检测,比较三组GDF15、TK1表达水平。同时对卵巢癌患者随访2年,根据是否生存分为两组,即生存组(n=41)、死亡组(n=10),比较两组临床病理特征,再经Cox回归模型分析生存情况与临床病理特征关系。结果卵巢癌组血清GDF15表达(816.65±88.46)ng/L、TK1表达水平(1.46±0.65)pmol/L高于良性组、对照组(P<0.05)。经ROC曲线分析,GDF15、TK1及两项联合预测卵巢癌的AUC分别为0.879、0.813、0.884。卵巢癌患者接受2年随访,生存组随访生存时间(22.56±1.15)个月高于死亡组生存时间(14.16±2.65)个月,差异有统计学意义(t=15.473,P<0.001),经Cox回归模型分析,TK1、GDF15的回归系数值分别为-2.208、-1.687,RR值分别为0.110、0.185,两者均会对生存时间产生负向影响关系;FIGO分期的回归系数值为3.059,会对生存时间产生正向影响关系。结论血清GDF15、TK1水平在卵巢癌患者中具有高表达性,且与卵巢癌发生、发展、预后密切相关,尤其对预后预测具有一定指导意义。

Objective To explore the expression of recombinant growth differentiation factor 15(GDF15)and thymidine kinase 1(TKI)in the serum of patients with ovarian cancer and their correlation with prognostic Cox regression.Methods Prospect selection was performed on 50 healthy physical examinees(control group),52 patients with ovarian benign disease(benign group),and 51 patients with ovarian cancer(ovarian cancer group)who underwent serum testing.Serum GDF15 and TK1 were tested,and the expression levels of GDF15 and TK1 in the three groups were compared.In the meantime,patients with ovarian cancer were followed up for 2 years,and they were divided into two groups according to survival or death of patients,namely survival group(n=41)and death group(n=10).The clinicopathological characteristics of the two groups were compared,and their crelationship with survival status was analyzed by Cox regression model.Results The serum GDF15 expression(816.65±88.46)ng/L and the TK1 expression level(1.46±0.65)pmol/L of the ovarian cancer group were higher than those of the benign group and the control group(P<0.05).According to ROC curve analysis,the AUC of GDF15,TK1 and the combination of the two in predicting ovarian cancer was 0.879,0.813,and 0.884,respectively.Patients with ovarian cancer were followed up for 2 years.The follow-up survival time of the survival group was(22.56±1.15)months,which was longer than that[(14.16±2.65)months]of the death group,and the difference was statistically significant(t=15.473,P<0.001).The Cox regression model showed that the regression coefficient values of TK1 and GDF15 were-2.208 and-1.687 respectively,and the RR values were 0.110 and 0.185 respectively.Both had a negative impact on survival time.The regression coefficient value of FIGO staging was 3.059,which had a positive impact on survival time.Conclusion Serum GDF15 and TK1 levels are highly expressed in patients with ovarian cancer,and are closely related to the occurrence,development and prognosis of ovarian cancer,which have certain guiding significance for prognostic prediction.