不同病理分期胰腺癌患者血清TK1和IGFBP2及RCAS1的表达水平及意义

Expression and significance of serum TK1,IGFBP2 and RCAS1 in patients with different pathological stages of pancreatic cancer

目的探讨不同病理分期胰腺癌患者血清TK1、IGFBP2和RCAS1表达水平变化及对患者预后不良的预测价值。方法选取2018年1月至2020年1月间西安工会医院收治的98例胰腺癌患者作为胰腺癌组,63例良性胰腺病变患者作为良性组,同期选择50例健康体检者作为对照组。检测受试者血中TK1、IGFBP2和RCAS1表达水平。对患者随访2年以上,记录患者预后情况。绘制卡米尔生存曲线,分析患者生存时间指标情况,绘制受试者工作特征曲线(ROC),分析各指标预测患者预后质量价值。结果胰腺癌组患者血清TK1、IGFBP2和RCAS1水平高于良性组和对照组,差异有统计学意义(P<0.05);Ⅳ期患者血清TK1、IGFBP2和RCAS1水平显著高于Ⅱ期和Ⅲ期,差异有统计学意义(P<0.05)。TK1低表达、IGFBP2低表达和RCAS1低表达患者生存时间均高于TK1高表达、IGFBP2高表达和RCAS1高表达患者,且差异均有统计学意义(均P<0.05)。TK1、IGFBP2和RCAS1表达水平预测胰腺癌患者预后质量的曲线下面积(AUC)均高于0.85,具有较高的临床应用价值,差异有统计学意义(P<0.05)。结论随着胰腺癌患者病理分期进展,其血清TK1、IGFBP2和RCAS1表达水平呈现明显的增高趋势,且TK1、IGFBP2和RCAS1对胰腺癌患者预后质量评估具有十分重要的临床应用价值。

Objective To analyze the changes in serum TK1,IGFBP2 and RCAS1 expression levels and their predictive value for poor prognosis in patients with pancreatic cancer at different pathological stages.Methods Ninety-eight patients with pancreatic cancer treated at Xi’an Labor Union Hospital were selected from January 2018 to January 2020 and were included in a pancreatic cancer group,63 patients with benign pancreatic lesions were included in a benign group,and 50 healthy individuals were selected and included in a control group.The expression levels of serum TK1,IGFBP2 and RCAS1 were detected in the participants.Patients were followed up for more than 2 years to record the prognosis.The Camille survival curve was drawn to analyze the survival indicators of patients,and receiver operating characteristic(ROC)curve was drawn to analyze the value and performance of each indicator in predicting the prognosis.Results The levels of serum TK1,IGFBP2 and RCAS1 were significantly higher in patients with pancreatic cancer than in the benign group and control group,and the difference was statistically significant(all P<0.05).The levels of serum TK1,IGFBP2 and RCAS1 were significantly higher in patients with stage IV pancreatic cancer than those with stage II and III pancreatic cancer,and the difference was statistically significant(all P<0.05).The survival was significantly higher in patients with low expression of TK1,IGFBP2 and RCAS1 than in patients with high expression of TK1,IGFBP2 and RCAS1,and the difference was statistically significant(all P<0.05).The area under the curve(AUC)of TK1,IGFBP2 and RCAS1 expression levels in predicting the quality of prognosis in patients with pancreatic cancer was higher than 0.85,which had high clinical value(all P<0.05).Conclusion With the progress of pathological staging in patients with pancreatic cancer,the expression levels of TK1,IGFBP2 and RCAS1 in blood show a significant upward trend,and TK1,IGFBP2 and RCAS1 in blood have very important clinical application value for the prediction of prognosis quality in patients with pancreatic cancer.