宫颈癌患者淋巴结转移的危险因素分析及血清TFF3、AIF-1、S100-A11、DKK1预测价值分析

Risk factors analysis of lymph node metastasis in patients with cervical cancer and predictive value analysis of serum TFF3, AIF-1, S100-A11 and DKK1

目的 探讨宫颈癌患者淋巴结转移的危险因素分析及血清三叶因子3(trefoil factor 3,TFF3)、同种异体移植物炎性因子-1(allograft inflammatory factor-1,AIF-1)、S100钙结合蛋白-A11(S100 calcium-binding protein-A11,S100-A11)、Wnt通路抑制因子Dickkopf-1(Wnt pathway inhibitor Dickkopf-1,DKK1)的预测价值。方法 选择2021年1月—2023年1月本院收治的71例宫颈癌患者作为研究对象,根据患者有无盆腔淋巴结转移分为淋巴结转移阳性组(28例)和淋巴结转移阴性组(43例)两组。收集两组患者临床病理特征,并检测血清TFF3、AIF-1、S100-A11、DKK1水平。结果 单因素分析显示,FIGO分期、宫旁浸润、肌层浸润、血清TFF3、S100-A11、DKK1是患者发生宫颈癌淋巴结转移的影响因素(P<0.05)。与年龄、分化程度、肿瘤大小、组织学类型、脉管浸润及血清AIF-1无关(P>0.05);Logistic多元回归分析显示,FIGO分期、宫旁浸润、肌层浸润及血清TFF3是影响宫颈癌淋巴结转移的独立因素(P<0.05);ROC曲线分析显示,TFF3对淋巴结转移有中等预测价值(AUC=0.649),明显大于机会参考线下面积(P<0.05)。而AIF-1、S100-A11、DKK1对淋巴结转移无预测价值(AUC分别为0.477、0.517、0.524),与机会参考线下面积比较无统计学意义(P>0.05)。结论 FIGO分期高、宫旁浸润、肌层浸润、血清TFF3异常升高是宫颈癌淋巴结转移的危险因素,血清TFF3有望成为预测宫颈癌淋巴结转移的新标志物;血清AIF-1、S100-A11、DKK1对宫颈癌淋巴结转移的预测效能不理想。

Objective To investigate the risk factors of lymph node metastasis in patients with cervical cancer and the predictive value of serum trefoil factor 3(TFF3),allograft inflammatory factor-1(AIF-1),S100 calcium-binding protein-A11(S100-A11)and Wnt pathway inhibitor Dickkopf-1(DKK1).Methods 71 patients with cervical cancer who were admitted to Suzhou Hospital of Anhui Medical University from January 2021 to January 2023 were selected as study subjects,and they were divided into a positive group(n=28)and a negative group(n=43)according to the presence of pelvic lymph node metastasis.Clinicopathological features of the two groups were collected,and serum levels of TFF3,AIF-1,S100-A11 and DKK1 were detected.Results Univariate factor analysis showed that FIGO staging,parametrial infiltration,muscle layer infiltration,serum TFF3,S100-A11,DKK1 were the influence factors of patients with cervical lymph node metastasis(P<0.05).It was not correlated with age,degree of differentiation,tumor size,histological type,vascular invasion and serum AIF-1(P>0.05).Logistic multiple regression analysis showed that FIGO stage,parametrial invasion,myometrial invasion and serum TFF3 were independent factors affecting lymph node metastasis of cervical cancer(P<0.05).ROC curve analysis showed that TFF3 had a moderate predictive value for lymph node metastasis(AUC=0.649),which was significantly larger than the chance reference line area(P<0.05).AIF-1,S100-A11,and DKK1 had no predictive value for lymph node metastasis(AUC=0.477,0.517,and 0.524,respectively),which was not statistically significant different from the chance reference line area(P>0.05).Conclusions High FIGO staging,parametrial infiltration,muscular infiltration and abnormal elevation of serum TFF3 are risk factors for cervical cancer lymph node metastasis,and serum TFF3 is expected to be a new marker for predicting cervical cancer lymph node metastasis. Serum AIF-1, S100-A11 and DKK1 are not ideal in predicting lymph node metastasis of cervical cancer.