凝血功能指标、孕激素和脂联素分子受体3与食管癌疾病进展和预后的关系

Relationship of coagulation function indexes,progestin and adipoQ receptor family member 3 with disease progression and prognosis of esophageal cancer

目的探讨凝血功能指标、孕激素和脂联素分子受体3(PAQR3)与食管癌疾病进展和预后的关系。方法选取82例食管癌患者和74例健康体检者,分别作为研究组和健康组,收集食管癌组织82例和癌旁5 cm处正常组织82例。比较食管癌组织和癌旁正常组织中PAQR3的表达情况,比较研究组和健康组的凝血功能指标[凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)、纤维蛋白原(FIB)],比较不同临床分期食管癌患者凝血功能指标及食管癌组织中PAQR3的表达情况。对患者进行2年随访,采用多元Logistic回归模型分析食管癌患者预后的影响因素。结果食管癌组织中PAQR3高表达率为69.51%,低于癌旁正常组织的91.46%,差异有统计学意义(P﹤0.05)。研究组患者的FIB、D-D水平均明显高于健康组,差异均有统计学意义(P﹤0.01)。Ⅰ~Ⅱ期食管癌患者的FIB、D-D水平均明显低于Ⅲ~Ⅳ期患者,Ⅰ~Ⅱ期食管癌患者食管癌组织中PAQR3高表达率明显高于Ⅲ~Ⅳ期患者,差异均有统计学意义(P﹤0.01)。随访2年后,82例食管癌患者生存63例,死亡19例。Logistic回归分析结果显示,FIB异常、D-D异常、PAQR3低表达均是食管癌患者生存情况的独立危险因素(P﹤0.01)。结论食管癌患者存在凝血功能异常及PAQR3表达下调,加强对食管癌患者凝血功能及PAQR3的干预,及时根据上述指标的变化情况调整诊疗计划,有助于延缓病情进展及改善预后。

Objective To investigate the relationship of coagulation function indexes,progestin and adipoQ receptor family member 3(PAQR3)with the progression and prognosis of esophageal cancer.Method A total of 82 patients with esophageal cancer and 74 healthy subjects were selected as the study group and the healthy group,respectively.Among them,82 cases of esophageal cancer tissues and 82 cases of normal tissues at 5 cm adjacent to the tumor were collected.The expression of PAQR3 in esophageal cancer tissues and adjacent normal tissues was compared.The coagulation function indexes[thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT),D-Dimer(D-D),fibrinogen(FIB)]were compared between the study group and the healthy group.The coagulation function indicators and the expression of PAQR3 in esophageal cancer tissues of patients with different clinical stages of esophageal cancer were compared.The patients were followed up for 2 years,and multivariate Logistic regression model was built to analyze the prognostic factors for patients with esophageal cancer.Result The high expression rate of PAQR3 in esophageal cancer tissues was 69.51%,which was lower than 91.46% in adjacent normal tissues,and the difference was statistically significant(P<0.05).The levels of FIB and D-D in the study group were significantly higher than those in the healthy group,and the differences were statistically significant(P<0.01).The levels of FIB and D-D in patients with stage Ⅰ-Ⅱ esophageal cancer were significantly lower than those in patients with stage Ⅲ-Ⅳ,and the high expression rate of PAQR3 in esophageal cancer tissue of patients with stage Ⅰ-Ⅱ esophageal cancer was significantly higher than that in patients with stage Ⅱ-Ⅳ,and the differences were statistically significant(P<0.01).After 2 years of follow-up,63 of 82 esophageal cancer patients survived and 19 died.Logistic regression analysis showed that abnormal FIB,abnormal D-D,and low expression of PAQR3 were independent risk factors for the survival of patients with esophageal cancer(P<0.01).Conclusion There are abnormal coagulation function and down-regulation of PAQR3 expression in patients with esophageal cancer.Strengthen the intervention of coagulation function and PAQR3 in patients with esophageal cancer,and timely adjusting the diagnosis and treatment plan for patients based on the alternations of the foregoing indicators,would do great help delay the progression of the disease and improve the prognosis.