肾癌患者外周血sTNFR-Ⅱ、sCD163预测切缘阳性的价值

The values of peripheral blood sTNFR-Ⅱand sCD163 in predicting the positive surgical margin in patients with renal cancer

目的:分析肾癌患者外周血可溶性肿瘤坏死因子受体Ⅱ(sTNFR-Ⅱ)、可溶性CD163(sCD163)预测切缘阳性的价值。方法:选取我院肾癌患者324例,同期健康体检者108例。Logistic回归分析患者术后切缘阳性的影响因素,应用相加模型评估血清sTNFR-Ⅱ、sCD163对肾癌患者术后切缘阳性的交互作用,并采用受试者工作特征(ROC)曲线分析血清sTNFR-Ⅱ、sCD163预测肾癌患者术后切缘阳性的价值。结果:肾癌患者血清sTNFR-Ⅱ、sCD163水平高于健康体检者(P<0.05);324例患者术后切缘阳性37例,切缘阴性287例,切缘阳性率为11.42%;血清sTNFR-Ⅱ、sCD163水平是肾癌患者术后切缘阳性的影响因素(P<0.05);血清sTNFR-Ⅱ、sCD163对患者术后切缘阳性存在协同作用,协同效应为二者单独存在产生效应之和的1.375倍(协同指数=1.375);血清sTNFR-Ⅱ水平>A、sCD163水平>B时肾癌患者术后切缘阳性风险较高,其AUC值分别为0.739、0.826,二者联合检测的AUC值为0.860。结论:肾癌患者血清sTNFR-Ⅱ、sCD163水平明显升高,二者对肾癌患者术后切缘阳性存在协同作用,其中血清sTNFR-Ⅱ>3.26μg·L^(-1)、sCD163>66.90 mg·ml-1时提示患者术后切缘阳性风险较高。

Objective:To analyze the predictive values of soluble tumor necrosis factor receptorⅡ(sTNFRⅡ)and soluble CD163(sCD163)in peripheral blood of patients with renal cancer.Methods:A total of 324 patients with renal cancer in our hospital were selected,and 108 healthy subjects during the same period were selected.Logistic regression analysis was used to analyze the influencing factors of postoperative positive surgical margins.An additive model was used to evaluate the interaction of serum sTNFR-Ⅱand sCD163 on positive postoperative margins in patients with renal cancer.The receiver operating characteristic(ROC)curve was used to analyze the values of serum sTNFR-Ⅱand sCD163 in predicting the positive postoperative margins of renal cancer patients.Results:The serum levels of sTNFR-Ⅱand sCD163 in patients with renal cancer were higher than those in healthy people(P<0.05).Of the 324 patients,37 had positive margins and 287 had negative margins,with a positive rate of 11.42%.The levels of serum sTNFR-Ⅱand sCD163 were the influencing factors of positive postoperative margins in patients with renal cancer(P<0.05).Serum sTNFR-Ⅱand sCD163 had a synergistic effect on the positive postoperative margin of patients,and the synergistic effect was 1.375 times the sum of the effects of the two alone(SI=1.375).When serum sTNFR-Ⅱlevel>A,sCD163 level>B,renal cancer patients had a higher risk of positive postoperative margins,and their AUC values were 0.739 and 0.826,respectively,and AUC of combination detection was 0.860.Conclusion:The serum levels of sTNFR-Ⅱand sCD163 in renal cancer patients are significantly increased,and the two have a synergistic effect on the positive postoperative margins of renal cancer patients.Among them,serum sTNFR-Ⅱ>3.26μg·L^(-1) and sCD163>66.90 mg·ml-1 indicate that patients have a higher risk of positive postoperative margins.