宫颈癌术前血清MAP19、OPN、AGR2水平及其预测术后2年内复发价值

Levels of mannan-binding lectin-associated protein 19,osteopontin and pregradient protein 2 of patients with cervical cancer before operation and their predictive values for the recurrence within 2 years after operation

目的:探讨宫颈癌术后复发的危险因素及甘露聚糖结合凝集素相关蛋白19(MAP19)、骨桥蛋白(OPN)、前梯度蛋白2(AGR2)的预测价值。方法:收集2016年1月-2021年1月本院诊治的宫颈癌患者250例临床资料,随访术后2年发生复发情况分为复发组(n=32),未复发者为未复发组(n=218),收集患者临床资料,分析宫颈癌术后复发的危险因素,检测血清MAP19、OPN、AGR2水平并采用受试者工作特征(ROC)曲线分析预测术后复发价值。结果:两组肿瘤直径、分化程度、肿瘤间质浸润、FIGO分期、淋巴结转移有差异,复发组血清MAP19(266.04±80.21μg/L)、OPN(61.25±20.14μg/L)、AGR2(12.44±3.14 ng/ml)水平高于未复发组(138.25±56.73μg/L、19.45±3.56μg/L、12.44±3.14 ng/ml),多因素非条件logistic分析,肿瘤直径≥4 cm、分化程度高分化、肿瘤间质浸润深肌层、FIGO分期IA1~IA2、淋巴结转移,以及MAP19、OPN、AGR2高水平均是宫颈癌术后复发的独立危险因素(均P<0.05);ROC分析显示,预测宫颈癌术后复发血清MAP19的曲线下面积(AUC)为0.702,灵敏度73.2%,特异度80.1%,截断值186.54μg/L;血清OPN的AUC为0.825,灵敏度76.4%,特异度82.5%,截断值34.76μg/L;血清AGR2的AUC为0.727,灵敏度74.6%,特异度79.8%,截断值7.46ng/ml。结论:宫颈癌术后复发患者术前血清MAP19、OPN、AGR2水平异常升高,是宫颈癌术后复发独立危险因素,且对预测宫颈癌术后2年内的复发有一定参考价值。

Objective:To explore the risk factors of the recurrence of cervical cancer of patients,and to study the predictive values of the levels of mannan-binding lectin-associated protein 19(MAP19),osteopontin(OPN),and pregra-dient protein 2(AGR2)of patients for their recurrence of cervical cancer.Methods:The clinical data of 250 patients with cervical cancer treated in hospital from January 2016 to January 2021 were collected in this study.Based on the recurrence of cervical cancer or not in the 2 years of follow up after operation,these patients were divided in 32 cases with the recurrence of cervical cancer in group A and 218 cases without the recurrence of cervical cancer in group B.The risk factors of the postoperative cervicalcancer recurrence of the patients were analyzed.The levels of serum MAP19,OPN and AGR2 of the patients in the two groups were detected.Receiver operator characteristic(ROC)curve was used to analyze the values of the serum MAP19,OPN and AGR2 levels of the patients for predicting their postoperative recurrence of cervical cancer.Results:There were significant differences in the diameter,the differentiation degree of tumor,the tumor stromal invasion,the tumor FIGO stage and the lymph node metastasis of the patients between the two groups.The levels of serum MAP19(266.04±80.21μg/L),OPN(61.25±20.14μg/L)and AGR2(12.44±3.14ng/ml)of the patients in group A were significantly higher than those(138.25±56.73μg/L,19.45±3.56μg/L and 12.44±3.14ng/ml)of the patients in group B.Multivariate unconditional logistic analysis showed that the tumor diameter≥4 cm,the high degree of tumor differentiation,the deep muscular invasion of tumor,the FIGO stage IA1-IA2,the lymph node metastasis,and the high levels of MAP19,OPN and AGR2 of the patients were the independent risk factors of their postoperative recurrence of cervical cancer(all P<0.05).ROC analysis showed that the area under the curve(AUC),the sensitivity,the specificity and the cut-off value of the serum MAP19 level of the patients for predicting their postoperative recurrence of cervical cancer were 0.702,73.2%,80.1% and 186.54pg/L,respectively.The AUC,the sensitivity,the specificity and the cut-off value of the serum OPN level of the patients for predicting their postoperative recurrence of cervical cancer were 0.825,76.4%,82.5% and 34.76μg/L,respectively.The AUC,the sensitivity,the specificity and the cut-off value of the serum AGR2 level of the patients for predicting their postoperative recurrence of cervical cancer were 0.727,74.6%,79.8% and 7.46ng/ml,respectively.Conclusion:The levels of serum MAP19,OPN and AGR2 of the patients with postoperative recurrence of cervical cancer increase abnormally,which are the independent risk factors for the postoperative recurrence of cervical cancer of the patients,and which have certain reference values for predicting the recurrence of cervical cancer of the patients within 2 years after surgery.