血管内皮生长因子、凝血功能指标与食管癌患者预后的关系

Relationship between vascular endothelial growth factor,coagulation function indicators and prognosis of patients with esophageal cancer

目的探讨血管内皮生长因子(VEGF)、凝血功能指标与食管癌患者预后的关系。方法选取106例食管癌患者和99例健康体检者,检测不同受试者、不同TNM分期食管癌患者血清VEGF、凝血功能指标[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)]。食管癌患者预后不良的影响因素采用多因素Logistic回归分析。结果食管癌患者VEGF、FIB、D-D水平均明显高于健康体检者,差异均有统计学意义(P﹤0.01)。中晚期食管癌患者VEGF、FIB、D-D水平均明显高于早期患者,差异均有统计学意义(P﹤0.01)。随访12个月,106例食管癌患者预后良好83例,预后不良23例。预后良好与预后不良食管癌患者肿瘤直径、分化程度、淋巴结转移情况、TNM分期、VEGF水平、FIB水平、D-D水平比较,差异均有统计学意义(P﹤0.01)。多因素Logistic回归分析结果显示,肿瘤直径﹥3 cm、分化程度为低分化、淋巴结转移、TNM分期为中晚期、VEGF﹥23 ng/L、FIB﹥4 g/L、D-D≥8μg/L均是食管癌患者预后不良的独立危险因素(P﹤0.05)。结论血清VEGF、FIB、D-D水平与食管癌患者的预后有关,检测上述指标对评估食管癌疾病进展、改善预后有重要意义。

Objective To explore the relationship between vascular endothelial growth factor(VEGF),coagulation function indicators and the prognosis of patients with esophageal cancer.Method A total of 106 esophageal cancer pa-tients and 99 healthy subjects were selected.Serum VEGF and coagulation function indicators[thrombin time(TT),pro-thrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D)]were detected in dif-ferent subjects and patients with esophageal cancer at different TNM stage.Multivariate Logistic regression was used to analyze the risk factors for poor prognosis in patients with esophageal cancer.Result The levels of VEGF,FIB,and D-D in patients with esophageal cancer were significantly higher than those in healthy subjects,and the differences were statis-tically significant(P<0.01).The levels of VEGF,FIB,and D-D in patients with intermediate and advanced esophageal cancer were significantly higher than those in early-stage patients,and the differences were statistically significant(P<0.01).After 12 months of follow-up,83 of the 106 esophageal cancer patients had a good prognosis and 23 had a poor prognosis.There were statistically significant differences in tumor diameter,degree of differentiation,lymph node metas-tasis,TNM stage,VEGF level,FIB level,and D-D level between esophageal cancer patients with good prognosis and poor prognosis(P<0.01).Multivariate Logistic regression analysis showed that tumor diameter>3 cm,poorly differenti-ated,lymph node metastasis,intermediate and advanced TNM stage,VEGF>23 ng/L,FIB>4 g/L,and D-D≥8μg/L were independent risk factors for poor prognosis in patients with esophageal cancer(P<0.05).Conclusion As serum VEGF,FIB,and D-D levels are related to the prognosis of patients with esophageal cancer,it is of great significance to perform regular detection on the above indicators for the assessment of esophageal cancer progression and improving the prognosis.