卵巢癌患者外周血TFF1、FBLN1的表达意义及其预后评估价值

Expression of TFF1 and FBLN1 in peripheral blood of patients with ovarian cancer and their prognostic value

目的探究卵巢癌患者外周血三叶因子1(TFF1)、腓骨蛋白1(FBLN1)的表达意义及其预后评估价值。方法回顾性选取2017年3月至2020年3月在南通市海门区人民医院诊疗的卵巢癌患者142例为研究对象,设为卵巢癌组。另外选取同期在本院体检健康女性100名作为对照组。收集所有受试者年龄、体重指数、初潮年龄、绝经、产次、孕次等基本临床资料。并根据术后3年预后情况将患者分为预后良好组(n=118)和预后不良组(n=24)。比较卵巢癌组与对照组、预后良好组和预后不良组外周血TFF1、FBLN1水平;采用Pearson相关性分析法分析乳腺癌患者外周血TFF1和FBLN1水平相关性;COX回归分析影响患者预后不良的因素;受试者操作特征(ROC)曲线分析TFF1和FBLN1水平在评估乳腺癌患者预后中的价值。结果与对照组比较,卵巢癌组体重指数显著升高[(25.71±3.68)kg/m^(2) vs.(24.63±3.42)kg/m^(2)],差异有统计学意义(P<0.05);两组年龄、初潮年龄、绝经、产次、孕次比较,差异均无统计学意义(P>0.05)。与对照组比较,卵巢癌组外周血TFF1[(1.47±0.45)ng/mL vs.(0.76±0.28)ng/mL]、FBLN1水平[(11.37±3.71)ng/mL vs.(6.24±2.03)ng/mL]均显著升高,差异均有统计学意义(P<0.05)。预后不良组外周血TFF1[(1.87±0.31)ng/mL vs.(1.38±0.25)ng/mL]、FBLN1水平[(15.21±2.89)ng/mL vs.(10.59±2.15)ng/mL]较预后良好组均显著升高,差异均有统计学意义(P<0.05)。卵巢癌患者外周血TFF1与FBLN1表达水平呈正相关(r=0.533,P<0.05)。COX回归分析显示,高水平TFF1和FBLN1均为卵巢癌患者预后不良的独立危险因素(P<0.05)。ROC曲线结果显示,外周血TFF1、FBLN1水平评估卵巢癌患者预后是否不良的曲线下面积(AUC)分别为0.870、0.863,两者联合预测的AUC为0.903,高于TFF1、FBLN1单独检测,特异度为96.61%,敏感度为75.00%。结论卵巢癌患者外周血TFF1、FBLN1水平显著升高,且预后不良患者TFF1、FBLN1水平显著高于预后良好患者,外周血TFF1、FBLN1在卵巢癌患者预后评估中具有重要价值。

Objective To investigate the expression of peripheral blood trefoil factor family 1(TFF1)and fibulin 1(FBLN1)in patients with ovarian cancer and their prognostic value.Methods A total of 142 cases of ovarian cancer patients treated in Haimen District People's Hospital from March 2017 to March 2020 were selected for the study,in addition,100 healthy women were regarded as the control group.The basic clinical data such as age,body mass index,menarche age,menopause,parity and pregnancy were collected.Meantime,according to the 3-year postoperative prognosis,the patients were categorized into the good prognosis group(n=118)and the poor prognosis group(n=24).The levels of TFF1 and FBLN1 in peripheral blood of ovarian cancer group and control group,good prognosis group and poor prognosis group were compared;the correlation between TFF1 and FBLN1 levels in peripheral blood of breast cancer patients was analyzed by Pearson correlation analysis;the influencing factors of poor prognosis in patients with ovarian cancer was analyzed by COX regression;the value of TFF1 and FBLN1 levels in evaluating the prognosis of breast cancer patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the body mass index of ovarian cancer group was obviously higher[(25.71±3.68)kg/m^(2) vs.(24.63±3.42)kg/m^(2)],and the difference was statistically significant(P<0.05);there were no significant differences in age,menarche age,menopause,parity and pregnancy between the two groups(P>0.05).Compared with the control group,the levels of TFF1[(1.47±0.45)ng/mL vs.(0.76±0.28)ng/mL]and FBLN1[(11.37±3.71)ng/mL vs.(6.24±2.03)ng/mL]in the peripheral blood of the ovarian cancer group were significantly increased,and the differences were statistically significant(P<0.05).The levels of TFF1[(1.87±0.31)ng/mL vs.(1.38±0.25)ng/mL]and FBLN1[(15.21±2.89)ng/mL vs.(10.59±2.15)ng/mL]in peripheral blood of patients in poor prognosis group were obviously higher than those of patients in good prognosis group,the differences were statistically significant(P<0.05).Pearson correlation analysis showed that there was a positive correlation between TFF1 and FBLN1 expression in peripheral blood of patients with ovarian cancer(r=0.533,P<0.05).COX regression analysis showed that high levels of TFF1 and FBLN1 were independent risk factors for poor prognosis of ovarian cancer patients(P<0.05).ROC results showed that the area under the curve(AUC)of peripheral blood TFF1 and FBLN1 levels to evaluate the poor prognosis of ovarian cancer patients were 0.870 and 0.863,respectively,the AUC predicted by the combination of the two methods was 0.903,which was higher than that detected by TFF1 and FBLN1 alone,with specificity of 96.61%and sensitivity of 75.00%.Conclusion Peripheral blood TFF1 and FBLN1 levels were significantly elevated in patients with ovarian cancer,and TFF1 and FBLN1 levels were significantly higher in patients with poor prognosis than in patients with good prognosis.The levels of TFF1 and FBLN1 in peripheral blood have important value in the prognosis evaluation of patients with ovarian cancer.