血清TGF-β1、Bcl-2及食管鳞癌组织MTDH表达水平与食管鳞癌患者临床预后的相关性

Correlation of the Expression Levels of Serum TGF-β1,Bcl-2 and MTDH in Esophageal Squamous Cell Carcinoma Tissues with Clinical Prognosis

目的:探讨血清转化生长因子-β1(TGF-β1)、B淋巴细胞瘤-2蛋白(Bcl-2)及食管鳞癌组织异黏蛋白(MTDH)表达水平与食管鳞癌患者临床预后的相关性。方法:以我院于2019年4月至2021年4月收治的食管鳞癌患者88例为研究对象。收集患者临床病理特征及血清TGF-β1、Bcl-2及食管鳞癌组织MTDH表达水平,分析不同病理特征患者血清TGF-β1、Bcl-2及食管鳞癌组织MTDH表达水平的差异。随访2年,按是否死亡将患者分为存活组、死亡组,比较两组患者血清TGF-β1、Bcl-2及食管鳞癌组织MTDH表达水平。经Spearson相关分析,分析血清TGF-β1、Bcl-2及食管鳞癌组织MTDH表达水平与临床预后的相关性。经受试者工作曲线(ROC)评估血清TGF-β1、Bcl-2及食管鳞癌组织MTDH表达水平预测食管鳞癌患者预后的价值。结果:Ⅲ+Ⅳ期食管鳞癌患者TGF-β1、Bcl-2、MTDH表达水平高于Ⅰ+Ⅱ期患者;低分化食管鳞癌患者TGF-β1、Bcl-2、MTDH表达水平高于中高分化患者;存在淋巴结转移食管鳞癌患者TGF-β1、Bcl-2、MTDH表达水平高于无淋巴结转移患者(P<0.05)。死亡组患者TGF-β1、Bcl-2、MTDH表达水平高于存活组(P<0.05)。Spearson分析结果显示,血清TGF-β1、Bcl-2及组织MTDH表达水平与TNM分期、分化程度、淋巴结转移呈正相关,r值0.264~0.523不等(P<0.05),与预后呈中高强度正相关,r值依次为0.532、0.478、0.636(P<0.05)。ROC结果显示:TGF-β1、Bcl-2、MTDH表达水平评估食管鳞癌预后预测价值较佳,AUC值依次为0.874、0.793、0.893;以MTDH预测价值最佳,灵敏度、特异度分别为93.70%、78.57%,此时最佳截断值为1.45。结论:食管鳞癌患者血清TGF-β1、Bcl-2及食管鳞癌组织MTDH表达水平与临床病理特征及预后均呈正相关,通过监测TGF-β1、Bcl-2及MTDH表达便于及时了解病情进展,且对预后评估具有较好预测价值。

Objective:To investigate the correlation of the expression levels of serum transforming growth factor-β1(TGF-β1),B-lymphoblastoma-2(Bcl-2)and metadherin(MTDH)in esophageal squamous cell carcinoma tissues with clinical prognosis of the patients.Methods:A total of 88 patients with esophageal squamous cell carcinoma admitted to our hospital from April 2019 to April 2021 were selected as the research objects.The clinicopathological features,serum TGF-β1,Bcl-2 expression levels and MTDH expression level in esophageal squamous cell carcinoma tissues were collected and analyzed.The patients were followed up for 2 years and were divided into the survival group and the death group according to whether they died or not.The expression levels of serum TGF-β1,Bcl-2 and MTDH in esophageal squamous cell carcinoma tissues were compared between the two groups.The correlation of serum TGF-β1,Bcl-2 levels and MTDH expression level in esophageal squamous cell carcinoma tissues with clinical prognosis of the patients was analyzed by Spearson analysis.The value of serum TGF-β1,Bcl-2 levels and MTDH expression level in esophageal squamous cell carcinoma tissues in predicting prognosis of patients with esophageal squamous cell carcinoma was evaluated by receiver operating curve(ROC).Results:The expression levels of TGF-β1,Bcl-2 and MTDH in esophageal squamous cell carcinoma patients in stageⅢ+Ⅳwere higher than those in stageⅠ+Ⅱ(P<0.05).The expression levels of TGF-β1,Bcl-2 and MTDH in low-differentiated esophageal squamous cell carcinoma patients were higher than those of middle and high-differentiated esophageal squamous cell carcinoma patients(P<0.05).The expression levels of TGF-β1,Bcl-2 and MTDH in patients with lymph node metastasis were higher than those without lymph node metastasis(P<0.05).The expression levels of TGF-β1,Bcl-2 and MTDH of patients in the death group were higher than those in the survival group(P<0.05).Spearson analysis showed that the expression levels of TGF-β1,Bcl-2 and MTDH were positively correlated with the TNM stage,differentiation degree and lymph node metastasis with r values ranging from 0.264 to 0.523(P<0.05),and were positively correlated with the prognosis,with r values of 0.532,0.478 and 0.636(P<0.05).ROC results showed that the expression levels of TGF-β1,Bcl-2 and MTDH had good prognostic value in evaluating the prognosis of esophageal squamous cell carcinoma,and the AUC values were 0.874,0.793 and 0.893 respectively.MTDH had the best prognostic value,and the sensitivity and specificity were 93.70%and 78.57%respectively,and the optimal cut-off value was 1.45.Conclusion:The expression levels of serum TGF-β1,Bcl-2 and MTDH in esophageal squamous cell carcinoma tissues are positively correlated with the clinicopathological features and prognosis of patients with esophageal squamous cell carcinoma.Monitoring the expression levels of TGF-β1,Bcl-2 and MTDH facilitate timely understanding of the disease progression,and has good predictive value for prognosis evaluation.