结直肠癌患者血清CRP/ALB、GDF-15、VEGF、IL-37水平与预后的关联

Association of serum CRP/ALB,GDF-15,VEGF,IL-37 expression and prognosis in patients with colorectal cancer

目的:探讨结直肠癌患者血清C反应蛋白/白蛋白比值(CRP/ALB)、生长分化因子-15(GDF-15)、血管内皮生长因子(VEGF)、白细胞介素-37(IL-37)水平与预后的关联。方法:选取2019年1月至2020年6月于新乡市中心医院接受化疗且化疗后随访至2023年2月的135例结直肠癌患者作为研究对象,化疗后随访2 a,根据是否复发、转移或死亡分为预后良好组(n=98)与预后不良组(n=37),对比两组化疗前,化疗后3、6个月血清CRP/ALB、GDF-15、VEGF、IL-37水平变化。采用Logistic回归模型分析化疗后6个月血清CRP/ALB、GDF-15、VEGF、IL-37水平对结直肠癌患者预后的影响;采用ROC曲线分析血清CRP/ALB、GDF-15、VEGF、IL-37水平预测结直肠癌患者预后的AUC。结果:化疗前、化疗后3个月,两组患者血清CRP/ALB、GDF-15、VEGF、IL-37水平差异无统计学意义(P>0.05);化疗后6个月,预后不良组血清CRP/ALB、GDF-15、VEGF水平高于预后良好组,IL-37水平低于预后良好组(P<0.05)。血清CRP/ALB、GDF-15、VEGF高水平组的复发率、转移率、死亡率高于低水平组(P<0.05),IL-37低水平组的复发率、转移率、死亡率高于高水平组(P<0.05)。Logistic回归分析显示血清CRP/ALB、GDF-15、VEGF高水平和L-37低水平是结直肠癌患者预后的影响因素(P<0.05)。ROC曲线分析显示,血清CRP/ALB、GDF-15、VEGF、IL-37水平预测结直肠癌患者预后的AUC(95%CI)分别为0.827(0.748~0.907)、0.833(0.758~0.908)、0.833(0.752~0.914)和0.926(0.882~0.969)(P<0.05)。结论:结直肠癌患者血清CRP/ALB、GDF-15、VEGF、IL-37水平呈异常表达趋势,且其表达水平与预后密切相关,动态监测有助于为预后判断提供参考。

Aim:To investigate the serum C-reactive protein/albumin ratio(CRP/ALB),growth differentiation factor-15(GDF-15),vascular endothelial growth factor(VEGF)and interleukin-37(IL-37)levels in colorectal cancer patients and their association with prognosis.Methods:A total of 135 patients with colorectal cancer who received chemotherapy in Xinxiang Central Hospital from January 2019 to June 2020 and were followed up until February 2023 after chemotherapy were selected as the study objects.The patients were followed up for 2 years after chemotherapy and divided into good prognosis group(n=98)and poor prognosis group(n=37)according to whether they had recurrence,metastasis or death.The serum levels of CRP/ALB,GDF-15,VEGF and IL-37 before chemotherapy and at 3,6 months after chemotherapy were compared between the 2 groups.Logistic regression model was used to analyze the effects of CRP/ALB,GDF-15,VEGF and IL-37 on the prognosis of patients with colorectal cancer.ROC curve was used to analyze the AUC value of serum CRP/ALB,GDF-15,VEGF and IL-37 predicting prognosis of patients with colorectal cancer.Results:There was no significant difference in serum CRP/ALB,GDF-15,VEGF and IL-37 between the 2 groups before and at 3 months after chemotherapy(P>0.05).At 6 months after chemotherapy,serum CRP/ALB,GDF-15 and VEGF in the poor prognosis group were higher than that in the good prognosis group,and IL-37 was lower than that in the good prognosis group(P<0.05).The recurrence rate,metastasis rate and death rate of groups with high serum CRP/ALB,GDF-15 and VEGF levels were higher than those of groups with low levels(P<0.05),and the recurrence rate,metastasis rate and death rate of group with low serum IL-37 level were higher than those of group with high level(P<0.05).Logistic regression model analysis showed that high levels of CRP/ALB,GDF-15,VEGF and low level of IL-37 were prognostic factors in patients with colorectal cancer(P<0.05).ROC curve analysis showed that the AUC values of serum CRP/ALB,GDF-15,VEGF and IL-37 in predicting prognosis of colorectal cancer patients were 0.827(0.748-0.907),0.833(0.758-0.908),0.833(0.752-0.914)and 0.926(0.882-0.969),respectively(P<0.05).Conclusion:The levels of CRP/ALB,GDF-15,VEGF and IL-37 in serum of patients with colorectal cancer are abnormal,and are related with prognosis,and dynamic monitoring may help to provide a reference for prognosis judgment.