中期宫颈癌患者术后血清Chemerin、Hmga1水平变化及对2年内复发的影响

Changes of postoperative serum Chemerin and high mobility group box al levels in patients with mid-stage cervical cancer and their effect on recurrence within 2 years

目的分析中期宫颈癌患者术后血清趋化素(Chemerin)、高迁移率族蛋白a1(Hmga1)水平变化及对2年内复发的影响。方法选取2018年6月至2020年5月海南医学院第一附属医院收治的237例中期宫颈癌患者作为观察组,另选取237例同期健康体检女性作为对照组。绘制受试者工作特征(ROC)曲线分析血清Chemerin、Hmga1水平评估中期宫颈癌患者2年内复发的价值,采用决策曲线、临床影响曲线分析血清Chemerin、Hmga1水平评估中期宫颈癌患者2年内复发的净受益率。分析血清Chemerin、Hmga1不同表达水平的中期宫颈癌患者复发情况。结果观察组术前及术后1周血清Chemerin、Hmga1水平均高于对照组,且观察组术后1周血清Chemerin、Hmga1水平低于术前(P<0.05)。ROC曲线显示,血清Chemerin、Hmga1水平联合检测评估中期宫颈癌2年内复发的曲线下面积(AUC)高于Chemerin、Hmga1水平单独评估的AUC。决策曲线显示,当风险阈值为0.10~0.80时,血清Chemerin、Hmga1水平联合检测的净受益率大于单独检测。血清Chemerin、Hmga1同时高表达时复发率较高。结论血清Chemerin、Hmga1水平与中期宫颈癌患者2年内复发密切相关,二者高水平表达预示复发风险较高,其可作为术后筛查高复发风险患者的辅助性指标。

Objective To analyze the changes of serum Chemerin and high mobility group box a1(Hmga1)levels in patients with mid-stage cervical cancer after surgery and their effect on recurrence within 2 years.Methods A total of 237 patients with mid-stage cervical cancer in First Affiliated Hospital of Hainan Medical College were selected as observation group,and 237 healthy women conducting healthy examination during the same period were selected as control group.Receiver operating characteristic(ROC)curve was used to analyze the value of serum Chemerin and Hmga1 in evaluating the value of recurrence in patients with mid-stage cervical cancer within 2 years.Decision curve and clinical impact curve were used to analyze serum Chemerin and Hmga1 to evaluate the net benefit rate of recurrence within 2 years in patients with mid-stage cervical cancer.The recurrence condition of mid-stage cervical cancer patients with different serum Chemerin and Hmga1 expression was analyzed.Results The serum levels of Chemerin and Hmga1 in the observation group were higher than those in the control group before and 1 week after surgery,and the serum levels of Chemerin and Hmga1 in the observation group were lower than those before surgery(P<0.05).ROC analysis showed that the area under curve(AUC)value of serum Chemerin and Hmga1 combined detection to evaluate the recurrence of mid-stage cervical cancer within 2 years was higher than that of Chemerin and Hmga1 alone.The decision curve shows that when the risk threshold is 0.10-0.80,the net benefit rate of combined detection of serum Chemerin and Hmga1 levels is greater than that of individual detection.The recurrence rate was higher when the serum Chemerin and Hmga1 were highly expressed at the same time.Conclusions Serum Chemerin and Hmga1 levels are closely related to recurrence within 2 years in patients with mid-stage cervical cancer,and their high expression indicates a higher risk of recurrence,which can be used as auxiliary indicators for postoperative screening of patients with high recurrence risk.