进展期胃癌患者血清circ_CPA4水平与一线化疗敏感性及预后的相关性分析

Correlation analysis of serum circ_CPA4 levels with first-line chemotherapy sensitivity and prognosis in patients with advanced gastric cancer

目的分析血清circ_CPA4水平与进展期胃癌(AGC)患者一线化疗敏感性及预后的相关性。方法选取2018年7月1日至2020年5月31日重庆市大足区人民医院接受一线化疗的无法行切除术的AGC患者病历。采用实时荧光定量聚合酶链反应测定血清circ_CPA4水平。根据治疗疗效,将AGC患者分为临床获益组和非临床获益组,并随访记录患者的总生存期(OS)。结果共纳入AGC患者86例,其中50例(58.14%)患者纳入临床获益组,36例(41.86%)患者纳入非临床获益组。根据AGC患者血清circ_CPA4水平中位值(1.81),将血清circ_CPA4水平≤1.81的患者纳入低水平组(n=43),>1.81的患者纳入高水平组(n=43)。高水平组患者临床获益率显著低于低水平组(34.00%比66.00%,P<0.05),中位OS更短[10.1(2.2~35.1)个月比24.7(2.4~46.1)个月,P<0.05]。血清circ_CPA4水平用于预测AGC患者一线化疗临床获益的灵敏度和特异性分别为63.90%和80.00%。多因素Cox回归分析结果显示,神经侵犯、糖类抗原199>37 U/mL和circ_CPA4水平>1.81为AGC患者预后的独立影响因素(P<0.05)。结论AGC患者血清circ_CPA4水平升高预示一线化疗反应较差,且OS更短。

Objective To analyze the correlation between serum circ_CPA4 levels and the sensitivity and prognosis of first-line chemotherapy in patients with advanced gastric cancer(AGC).Methods The medical records of unresectable AGC patients who received first-line chemotherapy in Chongqing Dazu District People's Hospital from July 1,2018 to May 31,2020 were selected.Serum circ_CPA4 level was analyzed by real-time fluorescence quantitative polymerase chain reaction.According to the therapeutic effect,AGC patients were divided into clinical benefit group and non-clinical benefit group,and the overall survival(OS)was recorded during follow-up.Results A total of 86 AGC patients were included.Among them,50 patients(58.14%)were included in the clinical benefit group and 36 patients(41.86%)were included in the non-clinical benefit group.According to the median value of serum circ_CPA4 level(1.81),patients with serum circ_CPA4 level≤1.81 were included in the low-level group(n=43),and patients with serum circ_CPA4 level>1.81 were included in the high-level group(n=43).The clinical benefit rate of patients in the high-level group was significantly lower than that in the low-level group(34.00%vs 66.00%,P<0.05),and the OS was shorter[10.1(2.2 to 35.1)months vs 24.7(2.4 to 46.1)months,P<0.05].The sensitivity and specificity of serum circ_CPA4 in predicting the clinical benefit of first-line chemotherapy in AGC patients were 63.90%and 80.00%.Multivariate Cox regression analysis showed that nerve invasion,carbohydrate antigen 199>37 U/mL and circ_CPA4 level>1.81 were independent prognostic factors for AGC patients(P<0.05).Conclusion Elevated serum circ_CPA4 levels in AGC patients with indicate poorer response to first-line chemotherapy and shorter OS.