免疫炎症指数、血管表皮生长因子和胰岛素生长因子-1联合预测接受根治性放疗食管癌患者预后的价值

Value of SⅡ,VEGF and IGF-1 in predicting prognosis of patients with esophageal cancer receiving radical radiotherapy

目的:探讨免疫炎症指数(SⅡ)、血管表皮生长因子(VEGF)和胰岛素生长因子-1(IGF-1)联合预测接受根治性放疗的食管癌患者预后的价值。方法:选取接受根治性放疗的食管癌患者128例,随访患者术后1年生存情况,分为存活组(n=98)和病死组(n=30),比较两组临床资料、SⅡ、VEGF和IGF-1差异,分析SⅡ、VEGF和IGF-1与临床病理、预后的关系。结果:病死组患者年龄、病灶位于胸下段比例、病灶长度>6 cm比例、TNM分期Ⅲ比例、低分化比例、非同步化疗比例、处方剂量<61.2 Gy比例明显高于存活组患者(均P<0.05)。病死组患者SⅡ、VEGF和IGF-1水平明显高于存活组患者(均P<0.05)。TNM分期Ⅲ期、低分化患者SⅡ明显高于TNM分期Ⅰ-Ⅱ期、中高分化患者(均P<0.05);病灶长度≥6 cm、TNM分期Ⅲ期、低分化患者VEGF水平明显高于病灶长度<6 cm、TNM分期Ⅰ-Ⅱ期、中高分化患者(均P<0.05);TNM分期Ⅲ期患者IGF-1水平明显高于TNM分期Ⅰ-Ⅱ期患者(均P<0.05)。Logistic回归分析显示:TNM分期、分化程度、SⅡ、VEGF和IGF-1是患者术后1年病死的影响因素(均P<0.05)。该方程预测患者术后1年病死的ROC曲线下面积为0.843,灵敏性和特异性分别为63.00%和91.00%。结论:SⅡ、VEGF和IGF-1水平与食管癌患者TNM分期、分化程度等临床病理有关,同时在预测食管癌患者根治性放疗预后方面有一定应用价值。

Objective:To investigate the value of Immunoinflammatory Index(SⅡ),vascular epidermal growth factor(VEGF)and insulin growth factor-1(IGF-1)in predicting prognosis of patients with esophageal cancer receiving radical radiotherapy.Methods:A total of 128 patients with esophageal cancer who received radical radiotherapy were selected and followed up 1 year after surgery.The patients were divided into survival group(98 cases)and death group(30 cases).The clinical data,SⅡ,VEGF and IGF-1 between the two groups were compared,and the relationship between SⅡ,VEGF,IGF-1 and clinicopathology and prognosis were analyzed.Results:The age,the proportion of lesion located in lower thoracic segment,the proportion of lesion length>6 cm,the proportion of TNM stageⅢ,the proportion of low differentiation,the proportion of non-synchronous chemotherapy and the proportion of prescription dose<61.2 Gy in death group were significantly higher than those in survival group(all P<0.05).The levels of SⅡ,VEGF and IGF-1 in death group were significantly higher than those in survival group(all P<0.05).The SⅡof patients with TNM stageⅢand low differentiation was significantly higher than that of patients with TNM stageⅠ-Ⅱand medium-high differentiation(all P<0.05).The level of VEGF in patients with lesion length≥6 cm,TNM stageⅢand low differentiation was significantly higher than that in patients with lesion length<6 cm,TNM stageⅠ-Ⅱand medium-high differentiation(all P<0.05).The level of IGF-1 in patients with TNM stageⅢwas significantly higher than that in patients with TNM stageⅠ-Ⅱ(P<0.05).Logistic regression analysis showed that TNM stage,differentiation degree,SⅡ,VEGF and IGF-1 were the influencing factors of death 1 year after surgery(all P<0.05).The area under ROC curve predicted by this equation was 0.843,and the sensitivity and specificity were 63.00%and 91.00%.Conclusion:The levels of SⅡ,VEGF and IGF-1 are related to clinical pathology such as TNM stage and differentiation degree,and have certain application value in predicting prognosis of patients after radical radiotherapy.