血清SGK1、TRAP1、FOXQ1与晚期胃癌患者化疗疗效和 预后的关系研究

Relationship between serum SGK1,TRAP1,FOXQ1 and chemotherapy efficacy and prognosis in patients with advanced gastric cancer

目的探讨晚期胃癌患者血清中血清和糖皮质激素调节蛋白激酶1(SGK1)、肿瘤坏死因子受体相关蛋白1(TRAP1)、叉头框蛋白Q1(FOXQ1)水平与化疗疗效和预后的关系。方法选择2017年10月至2020年10月该院收治的127例晚期胃癌患者(胃癌组),均接受SOX方案(奥沙利铂+替吉奥)化疗至少2个周期,根据化疗疗效分为有效组(52例)和无效组(75例)。另选择该院的62例体检健康的志愿者为对照组。检测并比较各组血清SGK1、TRAP1、FOXQ1水平。患者出院后随访2年。采用受试者工作特征(ROC)曲线分析SGK1、TRAP1、FOXQ1预测胃癌化疗疗效的价值,Kaplan-Meier生存曲线和Cox比例风险回归分析SGK1、TRAP1、FOXQ1与晚期胃癌化疗疗效及预后的关系。结果胃癌组血清SGK1、TRAP1、FOXQ1水平均高于对照组(P<0.05),无效组血清SGK1、TRAP1、FOXQ1水平均高于有效组(P<0.05)。SGK1、TRAP1、FOXQ1预测胃癌化疗疗效的曲线下面积(AUC)分别为0.836、0.833、0.778,联合预测的AUC为0.917,高于单独指标预测。SGK1高水平、TRAP1高水平、FOXQ1高水平的晚期胃癌患者总生存期(OS)生存率低于SGK1低水平、TRAP1低水平、FOXQ1低水平的晚期胃癌患者(Log-Rank χ^(2)=12.092、10.825、11.653,P<0.05)。多因素Cox比例风险回归结果显示,化疗耐药、SGK1高水平、TRAP1高水平、FOXQ1高水平是晚期胃癌患者预后不良的危险因素(P<0.05)。结论晚期胃癌患者血清SGK1、TRAP1、FOXQ1水平均升高,其与化疗疗效差及低OS生存率有关。

Objective To investigate the relationship between serum and glucocorticoid regulated protein kinase 1(SGK1),tumor necrosis factor receptor-associated protein 1(TRAP1),forkhead box Q1(FOXQ1)levels and chemotherapy efficacy and prognosis in patients with advanced gastric cancer.Methods A total of 127 patients with advanced gastric cancer(gastric cancer group)admitted to the hospital from October 2017 to October 2020 were selected.All patients received SOX regimen(oxaliplatin+tiggio)chemotherapy for at least 2 cycles,and were divided into effective group(52 cases)and ineffective group(75 cases)according to the chemotherapy efficacy.A total of 62 healthy volunteers in the hospital were selected as the control group.Serum SGK1,TRAP1 and FOXQ1 levels were detected and compared in each group.Patients were followed up for 2 years after discharge.Receiver operating characteristic(ROC)curve was used to analyze the value of SGK1,TRAP1 and FOXQ1 in predicting the efficacy of chemotherapy in gastric cancer.Kaplan-Meier survival curve and Cox proportional hazard regression analysis were used to analyze the relationship between SGK1,TRAP1,FOXQ1 and the chemotherapy efficacy and prognosis of advanced gastric cancer.Results The serum levels of SGK1,TRAP1 and FOXQ1 in the gastric cancer group were higher than those in the control group(P<0.05),and the serum levels of SGK1,TRAP1 and FOXQ1 in the ineffective group were higher than those in the effective group(P<0.05).The area under the curve(AUC)of SGK1,TRAP1 and FOXQ1 in predicting the chemotherapy efficacy of gastric cancer was 0.836,0.833 and 0.778,respectively.The AUC of combined prediction was 0.917,which was higher than that of single index prediction.The overall survival(OS)rate of advanced gastric cancer patients with high SGK1 level,TRAP1 level and FOXQ1 level were lower than that of patients with low SGK1 level,TRAP1 level and FOXQ1 level(Log-Rank χ^(2)=12.092,10.825,11.653,P<0.05).Multiariable Cox proportional hazard regression results showed that the risk proportion chemotherapy drug resistance,SGK1 high level,TRAP1 high level,FOXQ1 high level were risk factor for poor prognosis of patients with advanced gastric cancer(P<0.05).Conclusion Serum SGK1,TRAP1 and FOXQ1 levels are increased in patients with advanced gastric cancer,which are associated with poor chemotherapy efficacy and low OS rate.