AFP、PLR、ILF3水平变化评估胃癌术后早期复发转移的应用价值

The changes of AFP,PLR and ILF3 levels in the assessment of early postoperative recurrence and metastasis of gastric cancer

目的探究甲胎蛋白(AFP)、血小板与淋巴细胞比值(PLR)、白介素增强子结合因子3(ILF3)蛋白水平变化早评估胃癌术后复发转移的应用价值。方法选取安阳市中医院2018年4月至2021年4月收治的162例行胃癌根治术的患者临床资料,所有患者在术前进行AFP、PLR、ILF3检测,并在患者术后随访2年,根据患者术后早期复发转移情况将患者分为正常组(n=94)和转移组(n=68)。比较两组患者的一般资料和AFP、PLR、ILF3水平,采用多因素logistic回归分析影响胃癌患者术后早期复发转移的影响因素,并通过绘制受试者工作特征(ROC)曲线评估AFP、PLR、ILF3水平变化对胃癌患者术后早期复发转移的预测价值。结果两组的TNM分期、Borrmann分型、淋巴脉管侵袭、年龄、肿瘤直径、CEA、AFP、PLR、ILF3水平进行比较,差异有统计学意义(χ^(2)=52.438、54.035、12.635,t=3.097、2.619、2.667、4.885、4.059、4.226,P<0.05)。多因素logistic回归分析结果显示,TNM分期、Borrmann分型、年龄、肿瘤直径、肿瘤浸润深度、CEA、AFP、PLR、ILF3水平均是影响胃癌患者术后早期复发转移的因素(P<0.05)。ROC曲线结果显示,AFP、PLR、ILF3水平及三者联合预测的AUC面积分别为0.725、0.696、0.713、0.857,提示三者均具有一定的预测价值,且三者联合效果最优(P<0.05)。结论胃癌术后早期复发转移患者术前血清中AFP、PLR、ILF3水平均呈现高水平表达状态,三者对于胃癌术后早期复发转移预测具有一定的应用价值。

Objective To investigate the value of alpha⁃fetoprotein(AFP),platelet⁃lymphocyte ratio(PLR)and interleukin enhancer binding factor 3(ILF3)in early assessment of postoperative recurrence and metastasis of gastric cancer.Methods Clinical data of 162 patients undergoing radical gastrectomy admit⁃ted to Anyang Hospital of Traditional Chinese Medicine from April 2018 to April 2021 were retrospectively se⁃lected.AFP,PLR and ILF3 were detected in all patients before surgery,and the patients were followed up for 2 years after surgery.The patients were divided into normal group(n=94)and metastatic group(n=68)ac⁃cording to their early recurrence and metastasis.General data and AFP,PLR and ILF3 levels of patients in the two groups were compared.Multivariate logistic regression was used to analyze the factors affecting the early postoperative recurrence and metastasis of patients with gastric cancer,and the predictive value of changes in AFP,PLR and ILF3 levels in the early postoperative recurrence and metastasis of patients with gastric cancer was evaluated by drawing receiver operating characteristic(ROC)curve.Results TNM stage,Borrmann classification,lymphatic vessel invasion,age,tumor diameter,CEA,AFP,PLR and ILF3 levels were com⁃pared between the two groups,and the differences were statistically significant(χ^(2)=52.438,54.035,12.635,t=3.097,2.619,2.667,4.885,4.059,4.226,P<0.05).Multivariate logistic regression analysis showed that TNM stage,Borrmann classification,age,tumor diameter,tumor invasion depth,CEA,AFP,PLR and ILF3 levels were all factors that affected early postoperative recurrence and metastasis in gastric cancer patients(P<0.05).ROC curve results showed that the levels of AFP,PLR,ILF3 and AUC area predicted by the three were 0.725,0.696,0.713 and 0.857,respectively,suggesting that all three had certain prediction value and the combined effect of the three was the best(P<0.05).Conclusion The levels of AFP,PLR and ILF3 in the serum of patients with early postoperative recurrence and metastasis of gastric cancer showed high levels of ex⁃pression before operation,which has certain application value for the prediction of early postoperative recur⁃rence and metastasis of gastric cancer.