血清B淋巴细胞瘤-2基因、细胞角蛋白19的可溶性片段21-1表达与晚期食管癌放化疗患者预后的相关性

Correlation between the expression of serum B-cell lymphoma-2 and cytokeratin 19 fragment antigen 21-1 and the prognosis of patients with advanced esophageal cancer after radiotherapy and chemotherapy

目的 观察血清B淋巴细胞瘤-2基因(Bcl-2)、细胞角蛋白19的可溶性片段21-1(CYFRA21-1)在晚期食管癌(EC)患者中的表达情况,并分析二者与患者放化疗预后的关系。方法 前瞻选取2018年8月—2021年6月本院收治的130例晚期EC患者为研究对象,均接受6个周期的放化疗后至少随访4周,参照实体瘤评估标准评估患者放化疗效果作为短期预后观察指标,并分为预后不良组及预后良好组;调查员询问并记录患者基线资料,检测患者入院时、治疗结束时实验室指标,分析入院时血清Bcl-2、CYFRA21-1水平与晚期EC放化疗患者预后的关系。结果 130例晚期EC患者放化疗结束时血清Bcl-2、CYFRA21-1水平均较入院时降低(P<0.05);130例患者中,37例患者预后不良(评估为稳定、进展患者),占28.46%;预后不良组入院时血清癌胚抗原(CEA)、Bcl-2、CYFRA21-1水平均高于预后良好组(P<0.05);回归分析发现,入院时血清Bcl-2、CYFRA21-1过表达与晚期EC放化疗患者短期预后有关,可能作为预后不良的风险因子(OR>1,P<0.05);绘制ROC曲线,入院时血清Bcl-2、CYFRA21-1单独及联合预测患者短期预后不良风险的AUC均>0.8,有一定预测价值;相关性检验发现,晚期EC患者血清Bcl-2、CYFRA21-1水平之间成正相关(r=0.241,P=0.001)。结论 血清Bcl-2、CYFRA21-1过表达与晚期EC放化疗患者短期预后不良存在一定关系。

Objective This study aims to observe the expression of serum B-cell lymphoma-2(Bcl-2) and cytokeratin 19 fragment antigen 21-1(CYFRA21-1) in patients with advanced esophageal cancer(EC) and to analyze the relationship between the two and the prognosis of patients with radiotherapy and chemotherapy. Methods A total of 130 patients with advanced EC admitted to our hospital from August 2018 to June 2021 were prospectively selected as the research subjects, all patients were followed up for at least 4 weeks after 6 cycles of chemotherapy and radiotherapy. According to the evaluation criteria of solid tumor, the effect of radiotherapy and chemotherapy of patients was evaluated, regarded as a short-term prognostic indicator. The subjects were divided into poor prognosis group and good prognosis group;the baseline data of the patients were asked and recorded, the laboratory indexes of patients at admission and the end of treatment were detected, and the relationship between the serum Bcl-2 and CYFRA21-1 levels at admission and the prognosis of patients with advanced EC after radiotherapy and chemotherapy was analyzed. Results The serum levels of Bcl-2 and CYFRA21-1 in 130 patients with advanced EC at the end of chemotherapy and radiotherapy were decreased than those at admission(P<0.05);among 130 patients, 37 patients had poor prognosis(evaluated as stable and progressive patients), accounting for 28.46%;the serum CEA, Bcl-2 and CYFRA21-1 levels in poor prognosis group were higher than those in good prognosis group(P<0.05);regression analysis found that the overexpression of serum Bcl-2 and CYFRA21-1 at admission is related to the short-term prognosis of patients with advanced EC after radiotherapy and chemotherapy, which might be a risk factor for poor prognosis(OR>1, P<0.05);ROC curve showed that the AUC of serum Bcl-2 and CYFRA21-1 alone or combined to predict the risk of poor short-term prognosis were both greater than 0.8, which had certain predictive value;correlation test showed that there was a positive correlation between serum Bcl-2 and CYFRA21-1 levels in patients with advanced EC(r=0.241, P=0.001). Conclusion The overexpression of serum Bcl-2 and CYFRA21-1 is associated with poor short-term prognosis in patients with advanced EC after chemotherapy and radiotherapy.