血清HSP70、VEGF联合检测对可切除胰腺癌诊断及术后生存预测价值

Value of combined detection of serum HSP70 and VEGF in the diagnosis and prediction of post-operative survival of resectable pancreatic cancer

目的探讨血清热休克蛋白70(heat shock protein 70,HSP70)、血管内皮生长因子(vascular endothelial growth factor,VEGF)联合检测对可切除胰腺癌诊断及术后生存预测价值。方法选取2015年12月至2018年10月南方医科大学附属萍乡医院124例行手术治疗的Ⅰ~Ⅲ期原发性胰腺癌患者作为胰腺癌组,另选取16例同期于本院进行健康体检者作为对照组,检测胰腺癌组患者手术前和手术后以及对照组血清HSP70、VEGF水平,分析两项指标相关性,研究其与临床病理及预后的关系。结果血清HSP70、VEGF含量:术前>术后7d>术后1个月>对照组(P<0.05),胰腺癌组患者术前、术后7d、术后1个月血清HSP70水平与血清VEGF含量呈正相关(P<0.05)。胰腺癌组患者术前肿瘤>3cm、肿瘤分化程度低、临床分期Ⅲ期、淋巴结转移患者血清HSP70、VEGF含量分别高于肿瘤≤3cm、肿瘤分化程度高、临床分期Ⅰ期或Ⅱ期、未发生淋巴结转移者(P<0.05)。血清HSP70和VEGF对胰腺癌的诊断均有较好的特异性,联合诊断效果更好(P<0.05)。HSP70浓度和VEGF浓度均与胰腺癌患者术后生存时间呈负相关(P<0.05)。单因素回归分析和多因素Cox回归分析显示肿瘤直径、淋巴结转移、肿瘤淋巴结转移(tumor-node-metastasis,TNM)分期、分化程度、远处转移、HSP70和VEGF浓度均是胰腺癌预后的独立危险因素(P<0.05)。结论胰腺癌患者血清HSP70和VEGF与恶性生物学行为呈正相关,与生存时间呈负相关,是胰腺癌术后预后的独立危险因素。

Objective To investigate the value of combined detection of serum heat shock protein 70(HSP70)and vascular endothelial growth factor(VEGF)in the diagnosis and prediction of postoperative survival of stageⅠtoⅢresectable pancreatic cancer.Methods A total of 124 patients with primary resectable pancreatic cancer undergoing surgery in the Southern Medical University Affiliated Pingxiang Hospitalwere enrolled as the pancreatic cancer group from December 2015 to October 2018,while other 16 healthy controls during the same period were enrolled as the control group.The levels of serum HSP70 and VEGF in two groups were detected.The correlation between the two indicators was analyzed.The relationship with clinicopathology and prognosis was studied.Results The levels of serum HSP70 and VEGF in the pancreatic cancer group were higher than those in the control group before and after surgery(P<0.05).The levels of serum HSP70 and VEGF at 7 d and 1 month after surgery were lower than those before surgery in the pancreatic cancer group(P<0.05).In pancreatic cancer group,level of serum HSP70 was positively correlated with serum VEGF before surgery,at 7 d and 1 month after surgery(P<0.05).There were statistically significant differences in preoperative tumor>3cm,low differentiation degree of tumor,clinical stageⅢserum HSP70 and VEGF levels in patients with lymph node metastasis were higher than those with≤3cm tumor,high differentiation degree of tumor,clinical stageⅠorⅡand no lymph node metastasis(P<0.05).Both serum HSP70 and VEGF have good specificity for the diagnosis of pancreatic cancer,and the combined diagnosis effect is better(P<0.05).Both HSP70 concentration and VEGF concentration were negatively correlated with postoperative survival time of patients with pancreatic cancer(P<0.05).Univariate regression analysis and multivariate Cox regression analysis showed that tumor diameter,lymph node metastasis,tumor-node-metastasis(TNM)stage,differentiation degree,distant metastasis,HSP70 and VEGF concentration were independent risk factors for prognosis of pancreatic cancer(P<0.05).Conclusion Serum HSP70 and VEGF in patients with pancreatic cancer are positively correlated with malignant biological behavior,and negatively correlated with survival time,which are independent risk factors for postoperative prognosis of pancreatic cancer.