结直肠癌根治术后血清CCL18、MMP-16水平与肿瘤复发、转移的关系

Relationship of serum CCL18,MMP-16 levels with tumor recurrence and metastasis after radical resection of colorectal cancer

目的探讨腹腔镜下结直肠癌(CRC)根治术后患者血清C-C基序趋化因子配体18(CCL18)、基质金属蛋白酶-16(MMP-16)水平与肿瘤复发、转移的关系。方法选取2018年12月至2020年5月在保定市第二医院接受腹腔镜CRC根治术的125例CRC患者作为研究对象,根据随访情况,将其分为复发转移组和未复发转移组。采用酶联免疫吸附试验检测血清CCL18、MMP-16水平。绘制受试者工作特征(ROC)曲线分析CCL18、MMP-16对CRC患者术后发生肿瘤复发转移的预测价值。采用多因素Logistic回归分析CRC患者术后发生肿瘤复发转移的影响因素。结果随访结果显示,复发转移组37例和未复发转移组88例。复发组患者血清CCL18、MMP-16水平高于未复发组(P<0.05)。两组患者肿瘤最大径、TNM分期、淋巴结转移比较,差异均有统计学意义(P<0.05)。血清CCL18、MMP-16联合预测CRC患者术后发生肿瘤复发转移的曲线下面积(AUC)高于各指标单项检测的AUC(ZCCL18-联合=2.734,P=0.006;ZMMP-16-联合=3.327,P<0.001)。CCL18高表达(>1.58 ng/mL)患者3年复发转移率[70.73%(29/41)]高于CCL18低表达(≤1.58 ng/mL)患者[9.52%(8/84)],差异有统计学意义(χ^(2)=49.534,P<0.001)。MMP-16高表达(>143.46 ng/mL)患者3年复发转移率[71.11%(32/41)]高于MMP-16低表达(≤143.46 ng/mL)患者[6.25%(5/80)],差异有统计学意义(χ^(2)=58.143,P<0.001)。多因素Logistic分析结果显示,CCL18、MMP-16是CRC患者术后发生肿瘤复发转移的影响因素(P<0.05)。结论CRC根治术后患者血清CCL18、MMP-16水平较高,与肿瘤复发、转移密切相关。

Objective To investigate the relationship of serum C-C chemokine ligand 18(CCL18),matrix metalloproteinase-16(MMP-16)levels with tumor recurrence and metastasis in patients with colorectal cancer(CRC)after laparoscopic radical surgery.Methods From December 2018 to May 2020,125 CRC patients who underwent laparoscopic radical surgery in the Second Hospital of Baoding were selected and divided into recurrent metastasis group and non-recurrent metastasis according to the follow-up.Serum CCL18 and MMP-16 levels were detected by enzyme-linked immunosorbent assay.The receiver operating characteristic(ROC)curve was applied to analyze the predictive value of CCL18 and MMP-16 levels for tumor recurrence and metastasis in CRC patients after radical surgery.Multivariate Logistic regression was used to analyze the influencing factors of tumor recurrence and metastasis in CRC patients after radical surgery.Results The follow-up results showed 37 cases in the recurrent metastasis group and 88 cases in the non-recurrent metastasis group.The serum levels of CCL18 and MMP-16 in the recurrent metastasis group were higher than those in the non-recurrent metastasis group(P<0.05).There were statistically significant differences in maximum tumor diameter,TNM stage and lymph node metastasis between the two groups(P<0.05).The area under the curve(AUC)of serum CCL18 and MMP-16,in combination,to predict tumor recurrence and metastasis in CRC patients after surgery was higher than the AUC of CCL18 and MMP-16 alone(Z CCL18-combination=2.734,P=0.006;Z MMP-16-combination=3.327,P<0.001).The 3-year recurrence and metastasis rate of patients with high CCL18 expression(>1.58 ng/mL)was 70.73%(29/41),which was higher than 9.52%(8/84)of patients with low CCL18 expression(≤1.58 ng/mL),and the difference was statistically significant(χ^(2)=49.534,P<0.001).The 3-year recurrent metastasis rate of patients with high MMP-16 expression(>143.46 ng/mL)was 71.11%(32/41),which was higher than 6.25%(5/80)of patients with low MMP-16 expression(≤143.46 ng/mL),and the difference was statistically significant(χ^(2)=58.143,P<0.001).Multivariate Logistic regression results showed serum CCL18,MMP-16 were the influencing factors for tumor recurrence and metastasis in CRC patients after radical surgery(P<0.05).Conclusion The serum levels of CCL18 and MMP-16 are high in patients with CRC after radical surgery,which are closely related to tumor recurrence and metastasis.