血清TGF-α、TGF-β1、IL-37预测直肠癌腹腔镜术后复发转移的价值

Value of serum TGF-α,TGF-β1 and IL-37 in predicting recurrence and metastasis of rectal cancer after laparoscopic surgery

目的研究血清转化生长因子-α(TGF-α)、转化生长因子-β1(TGF-β1)、白细胞介素-37(IL-37)预测直肠癌腹腔镜术后复发转移的价值。方法回顾性纳入2019年1月至2020年12月攀枝花市中西医结合医院收治的102例直肠癌患者为研究对象,患者均接受腹腔镜直肠癌根治术,术后随访1年,根据患者是否发生复发转移分为复发转移组(n=24)和未复发转移组(n=78)。收集所有患者临床资料,包括性别、年龄、体重指数、有无吸烟史和饮酒史、有无梗阻、肿瘤直径、TNM分期、分化程度、有无脉管浸润、有无淋巴结转移;术后1 d检测血清TGF-α、TGF-β1、IL-37水平;采取非条件Logistic逐步回归分析直肠癌腹腔镜术后复发转移的影响因素;以受试者工作特征(ROC)曲线分析血清TGF-α、TGF-β1、IL-37预测直肠癌腹腔镜术后复发转移的价值。结果与未复发转移组相比,复发转移组TNM分期Ⅲ~Ⅳ期、低分化、有淋巴结转移的患者比例较高,并且血清TGF-α、TGF-β1水平较高,IL-37水平较低,差异均有统计学意义(P<0.05)。经多因素Logistic回归性分析,TNM分期Ⅲ~Ⅳ期、低分化、有淋巴结转移、TGF-α≥16.172 ng/mL、TGF-β1≥0.813 ng/mL、IL-37≤27.625 pg/mL是直肠癌腹腔镜术后复发转移的影响因素(P<0.05)。经ROC曲线分析,TGF-α≥16.172 ng/mL、TGF-β1≥0.813 ng/mL、IL-37≤27.625 pg/mL是预测直肠癌腹腔镜术后复发转移的最佳截断值(P<0.05)。结论血清TGF-α、TGF-β1、IL-37对直肠癌腹腔镜术后复发转移具有较好的预测价值,临床可通过检测以上血清指标对患者预后进行预测评估,对于术后复发转移高风险的患者及时采取相应的干预措施,改善患者的生存结局。

Objective To study the value of serum transforming growth factor-α(TGF-α),transforming growth factor-β1(TGF-β1)and interleukin-37(IL-37)in predicting recurrence and metastasis of rectal cancer after laparoscopic surgery.Methods A total of 102 patients with rectal cancer were included in Panzhihua City Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2020.All patients received laparoscopic radical resection of rectal cancer and were followed up for one year after surgery.According to whether patients had recurrence and metastasis,they were divided into a recurrence and metastasis group(n=24)and a non-recurrence and metastasis group(n=78).Clinical data of all patients were collected,including gender,age,BMI,smoking and drinking history,obstruction,tumor diameter,TNM stage,degree of differentiation,vascular invasion and lymph node metastasis.Serum TGF-α,TGF-β1 and IL-37 levels were detected 1 day after operation.Non-conditional Logistic stepwise regression was used to analyze the factors influencing the recurrence and metastasis of rectal cancer after laparoscopic surgery.The value of serum TGF-α,TGF-β1 and IL-37 in predicting recurrence and metastasis of rectal cancer after laparoscopic surgery was analyzed by receiver operating characteristic(ROC).Results Compared with the non-recurrence and metastasis group,the proportion of patients with TNM stageⅢ-Ⅳ,low differentiation and lymph node metastasis was higher in the recurrence and metastasis group,and the serum levels of TGF-αand TGF-β1 were higher and the level of IL-37 was lower in the recurrence and metastasis group(P<0.05).Multivariate Logistic regression analysis showed that TNM stageⅢ-Ⅳ,low differentiation,lymph node metastasis,TGF-α≥16.172 ng/mL,TGF-β1≥0.813 ng/mL,IL-37≤27.625 pg/mL were the factors influencing the recurrence and metastasis of colorectal cancer after laparoscopic surgery(P<0.05).ROC analysis showed that TGF-α≥16.172 ng/mL,TGF-β1≥0.813 ng/mL,IL-37≤27.625 pg/mL were the best cut-off values for predicting the recurrence and metastasis of colorectal cancer after laparoscopic surgery(P<0.05).Conclusion Serum TGF-α,TGF-β1,IL-37 has good predictive value for postoperative recurrence and metastasis of rectal cancer after laparoscopic surgery.By detecting the above serum indicators,the prognosis of patients can be predicted and evaluated.For patients with high risk of postoperative recurrence and metastasis,corresponding intervention measures can be taken in a timely manner to improve their survival outcomes.