血清MMP-2、NF-κB水平对进展期胃癌患者新辅助化疗效果的影响及评估价值

Influence and evaluation value of serum MMP-2 and NF-κB levels on the effect of neoadjuvant chemotherapy in patients with advanced gastric cancer

目的分析血清基质金属蛋白酶2(MMP2)、核因子κB(NF-κB)水平对进展期胃癌患者新辅助化疗效果的影响及评估价值。方法选取接受新辅助化疗的102例进展期胃癌患者作为研究对象。化疗3个周期后随访1个月,评估新辅助化疗效果,根据新辅助化疗效果将患者分为化疗无效组(n=45)与化疗有效组(n=57)。比较两组患者的一般资料及血清癌胚抗原、糖类抗原19-9(CA19-9)、MMP2、NF-κB水平。采用Logistic回归模型分析影响进展期胃癌患者新辅助化疗效果的因素。绘制受试者工作特征(ROC)曲线,分析新辅助化疗前血清MMP2、NF-κB水平对进展期胃癌患者化疗效果的评估价值。结果102例进展期胃癌患者接受新辅助化疗的有效率为55.88%(57/102)。化疗无效组患者血清癌胚抗原、CA19-9、MMP2、NF-κB水平均高于化疗有效组(均P<0.05)。多因素Logistic回归分析结果显示,新辅助化疗前血清癌胚抗原、CA19-9、MMP2、NF-κB水平升高是进展期胃癌患者化疗无效的危险因素(均P<0.05)。ROC曲线分析结果显示,新辅助化疗前血清MMP2、NF-κB水平取最佳截断值时二者单独及联合评估进展期胃癌患者化疗无效的ROC曲线下面积均>0.70,且二者联合评估效能更佳。结论新辅助化疗前血清MMP2、NF-κB水平升高是进展期胃癌患者化疗无效的危险因素,二者可作为评估化疗有效性的指标,且二者联合评估效能更佳。

Objective To analyze the influence and evaluation value of serum matrix metalloproteinase 2(MMP2)and nuclear factor kappa B(NF-κB)levels on the effect of neoadjuvant chemotherapy in patients with advanced gastric cancer.Methods A total of 102 patients with advanced gastric cancer receiving neoadjuvant chemotherapy were selected as the research subjects.All patients were followed up for 1 month after 3 cycles of chemotherapy to evaluate the effect of neoadjuvant chemotherapy,and they were divided into ineffective chemotherapy group(n=45)or effective chemotherapy group(n=57)according to the effect of neoadjuvant chemotherapy.The general data,serum carcino-embryonic antigen,carbohydrate antigen 19-9(CA19-9),MMP2,and NF-κB levels were compared between the two groups.The Logistic regression model was used to analyze the factors in affecting the effect of neoadjuvant chemotherapy in patients with advanced gastric cancer.The receiver operating characteristic(ROC)curve was drawn to analyze the evaluation value of pre-neoadjuvant chemotherapy serum MMP2 and NF-κB levels on the effect of chemotherapy in patients with advanced gastric cancer.Results The effective rate of 102 patients with advanced gastric cancer after receiving neoadjuvant chemotherapy was 55.88%(57/102).The levels of serum carcino-embryonic antigen,CA19-9,MMP2,and NF-κB in the ineffective chemotherapy group were higher than those in the effective chemotherapy group(all P<0.05).The results of multivariate Logistic regression analysis revealed that the pre-neoadjuvant chemotherapy elevated levels of serum carcino-embryonic antigen,CA19-9,MMP2,and NF-κB were the risk factors for ineffective chemotherapy in patients with advanced gastric cancer(all P<0.05).The results of ROC curve analysis indicated that when serum MMP2 and NF-κB levels were determined as the optimal cut-off value before neoadjuvant chemotherapy,the areas under the ROC curve of the two indices for alone and jointly evaluating ineffective chemotherapy in advanced gastric cancer patients were all>0.70,and the combination of the two indices exerted a more favorable evaluation efficiency.Conclusion Pre-neoadjuvant chemotherapy elevated serum MMP2 and NF-κB levels were the risk factors for ineffective chemotherapy in patients with advanced gastric cancer,both of the two can be regarded as effective indices for evaluating the effectiveness of chemotherapy,and the combination of the two indices exerts a more favorable evaluation efficiency.