甲状腺髓样癌血浆二肽基肽酶-4水平及临床意义

Clinical significance of plasma dipeptidyl peptidase-4 level in medullary thyroid carcinoma

目的探究血浆二肽基肽酶-4(DPP4)与甲状腺髓样癌(MTC)术后无病生存期(DFS)、总生存期(OS)、生化治愈之间的关系。方法收集2012年至2022年在邢台市人民医院就诊的144例MTC患者,采用酶联免疫吸附法测定血浆DPP4水平,分析血浆DPP4水平与MTC临床病理特征以及预后的关系。结果MTC术后存活组(n=131)血浆DPP4水平显著低于死亡组(n=12),MTC术后未复发组(n=120)血浆DPP4水平显著低于复发组(n=23),差异均有统计学意义(P<0.001)。血浆DPP4水平与性别、肿瘤数目、淋巴结清扫总数、转移性淋巴结数量、甲状腺外扩张、病理T分期、病理N分期、生存和复发均有关(P<0.05)。Kaplan-Meier结果显示,血浆DPP4≥0.12 ng/L组MTC患者术后OS、DFS更低(P<0.05)。与获得生化治愈患者比较,未获得生化治愈患者术前血浆DPP4≥0.12 ng/L比例更高(P<0.001)。结论术前血浆DPP4水平升高与MTC患者预后不良有关,具有成为低侵入性预后生物标志物的潜力。

Objective To investigate the relationship between plasma dipeptidyl peptidase-4(DPP4)and disease-free survival(DFS),overall survival(OS)and biochemical cure after surgery for medullary thyroid carcinoma(MTC).Methods One hundred and forty-four MTC patients in our hospital from 2012 to 2022 were collected.Plasma DPP4 levels were determined by ELISA,and the relationship between plasma DPP4 levels and clinicopathological features and prognosis of MTC was analyzed.Results The plasma DPP4 level in the MTC survival group(n=131 cases)was significantly lower than that in the death group(n=12 cases),and the plasma DPP4 level in the non-recurrence group(n=120 cases)was significantly lower than that in the recurrence group(n=23 cases),with statistical significance(P<0.001).Plasma DPP4 levels were correlated with sex,number of tumors,total number of lymph nodes dissected,number of metastatic lymph nodes,extrathyroid dilatation,pathological T stage,pathological N stage,survival and recurrence(P<0.05).Kaplan-Meier results showed that the postoperative OS and DFS of MTC patients in the plasma DPP4≥0.12 ng/L group were lower(P<0.05).The proportion of plasma DPP4≥0.12 ng/L was higher in patients without biochemical cure than in patients with biochemical cure(P<0.001).Conclusion Preoperative elevated plasma DPP4 level is associated with poor prognosis in MTC patients and has the potential to be a prognosis biomarker of low invasive.