血清irisin、DJ-1与非肌层浸润性膀胱癌患者TURBT术后复发的关系研究

Study on the Relationship between Serum Irisin,DJ-1 and Recurrence after TURBT in Patients with Non-Muscle Invasive Bladder Cancer

目的:研究血清鸢尾素(Irisin)、丝裂原依赖性癌基因(DJ-1)与非肌层浸润性膀胱癌(NMIBC)患者经尿道膀胱肿瘤电切术(TURBT)术后复发的关系。方法:选择从2020年1月到2022年1月在我院接受TURBT术治疗的NMIBC患者180例作为研究对象。所有患者均予以TURBT手术治疗,检测并对比两组术前血清Irisin及DJ-1水平。收集NMIBC患者的临床资料,建立多因素Logistic回归模型分析NMIBC患者TURBT术后复发的影响因素。受试者工作特征(ROC)曲线评价血清Irisin、DJ-1对NMIBC患者TURBT术后复发的预测价值。结果:180例患者中,复发42例,占比23.33%,纳入复发组。未复发138例,占比76.67%,纳入未复发组。复发组的血清Irisin水平较未复发组更低,而DJ-1水平较未复发组更高(P<0.05)。复发组临床TNM分期为T1期、组织学分级为低分化以及肿瘤数目为多发的患者比例均较未复发组更高(P<0.05)。多因素Logistic回归分析结果显示,临床TNM分期为T1期、组织学分级为低分化、肿瘤数目为多发、血清Irisin降低、DJ-1升高为患者术后复发危险因素。ROC分析结果显示,血清Irisin、DJ-1联合检测对NMIBC患者TURBT术后复发的预测价值最高,联合检测的曲线下面积(AUC)为0.858,敏感度为94.32%,特异度为79.34%,分别高于各项指标单独检测。结论:血清Irisin降低、DJ-1升高与NMIBC患者TURBT术后复发有关,二者联合检测对TURBT术后复发具有较高的预测价值。

Objective:To study the relationship between serum irisin(Irisin),mitogen-dependent oncogene(DJ-1)and recurrence after transurethral resection of bladder tumor(TURBT)in patients with non-muscle invasive bladder cancer(NMIBC).Methods:180 NMIBC patients who underwent TURBT in our hospital from January 2020 to January 2022 were selected as the study subjects.All patients were treated with TURBT,and the levels of serum Irisin and DJ-1 were detected and compared between two groups before operation.The clinical data of NMIBC patients were collected,and the influencing factors of recurrence after TURBT in NMIBC patients were analyzed by established multivariate Logistic regression model.The predictive value of serum Irisin and DJ-1 for recurrence after TURBT in NMIBC patients was evaluated by receiver operating characteristic(ROC)curve.Results:Among the 180 patients,42 cases recurred,accounting for 23.33%,and were included in recurrence group.There were 138 cases of non-recurrence,accounting for 76.67%,which were included in non-recurrence group.The serum Irisin level in recurrence group was lower than that in non-recurrence group,while the DJ-1 level was higher than that in non-recurrence group(P<0.05).The proportion of patients with clinical TNM stage T1,organizational classification into poorly differentiated and multiple tumors in recurrence group was higher than that in non-recurrence group(P<0.05).Multivariate Logistic regression analysis showed that,clinical TNM stage was T1 stage,organizational classification was poorly differentiated,the number of tumors was multiple,serum Irisin decreased and DJ-1 increased were risk factors for postoperative recurrence.The results of ROC analysis showed that,the combined detection of serum Irisin and DJ-1 had the highest predictive value for recurrence after TURBT in NMIBC patients.The area under the curve(AUC)of the combined detection was 0.858,the sensitivity was 94.32%,and the specificity was 79.34%,which was higher than that of each index alone.Conclusion:The decrease of serum Irisin and the increase of DJ-1 are relate to the recurrence of NMIBC patients after TURBT,and the combine detection of the two has a high predictive value for the recurrence after TURBT.