中晚期食管癌患者放疗前血清TGF-β1、TSP1、SCCA水平与放疗效果的相关性研究

Correlation between Serum TGF-β1,TSP1,SCCA Levels and Radiotherapeutic Effect in Patients with Advanced Esophageal Cancer before Radiotherapy

目的 分析中晚期食管癌患者放疗前血清转化生长因子-β1(TGF-β1)、血小板反应蛋白1(TSP1)、鳞状细胞癌抗原(SCCA)水平与放疗效果的相关性,以利于临床治疗方案的制订、防止延误治疗。方法 回顾分析2019年6月至2023年6月收治的109例中晚期食管癌放疗患者的临床资料,根据放疗效果分为无效组21例和有效组88例。比较2组患者临床资料,应用二元Logistic回归模型分析中晚期食管癌患者放疗效果的影响因素,绘制受试者工作特征(ROC)曲线分析放疗前TGF-β1、TSP1、SCCA对中晚期食管癌患者放疗效果的预测价值。结果 无效组临床分期Ⅳ期、放疗剂量≤60 Gy的患者比例高于有效组(P<0.05)。2组放疗后血清TGF-β1、SCCA水平均较放疗前降低,TSP1水平均较放疗前升高(P<0.05);有效组放疗前后血清TGF-β1、SCCA水平均低于无效组,TSP1水平均高于无效组(P<0.05,P<0.01)。二元Logistic回归分析显示:临床分期及放疗前血清TGF-β1、TSP1、SCCA水平均为中晚期食管癌患者放疗效果的危险因素(P<0.01)。ROC曲线分析显示,放疗前血清TGF-β1、TSP1、SCCA水平及三者联合预测中晚期食管癌患者放疗效果的预测价值均较好。随访12个月,有效组生存率为89.77%(79/88)高于无效组的66.67%(14/21),差异有统计学意义(P<0.01)。结论 中晚期食管癌患者放疗效果与临床分期及放疗前血清TGF-β1、TSP1、SCCA水平存在密切联系,临床可通过检测放疗前血清TGF-β1、TSP1、SCCA水平预测中晚期食管癌患者放疗效果,有助于指导临床治疗方案的制订,从而防止延误治疗,提高患者生存率。

Objective To analyze the correlation between the levels of serum transforming growth factor-β1(TGF-β1),thrombospondin-1(TSP1),squamous cell carcinoma antigen(SCCA)and radiotherapeutic effect in patients with advanced esophageal cancer before radiotherapy,so as to facilitate the formulation of clinical treatment plans and prevent delayed treatment.Methods The clinical data of 109 patients with advanced esophageal cancer treated with radiotherapy from June 2019 to June 2023 were retrospectively analyzed and divided into an ineffective group(n=21)and an effective group(n=88)according to the radiotherapeutic effect.The clinical data of the two groups were compared,and the factors influencing the radiotherapeutic effect of patients with advanced esophageal cancer were analyzed by binary Logistic regression model.The predictive value of TGF-β1,TSP1 and SCCA before radiotherapy was analyzed by drawing receiver operating characteristic(ROC)curve.Results The proportion of patients with clinical stageⅣand radiotherapy dose≤60 Gy in the ineffective group was higher than that in the effective group(P<0.05).The serum levels of TGF-β1 and SCCA in the two groups after radiotherapy were lower than those before radiotherapy,while the levels of TSP1 were higher than those before radiotherapy(P<0.05).Serum TGF-β1 and SCCA levels in the effective group were lower than those in the ineffective group before and after radiotherapy,while TSP1 levels were higher than those in the ineffective group(P<0.05,P<0.01).Binary Logistic regression analysis showed that clinical stage and serum TGF-β1,TSP1 and SCCA levels before radiotherapy were all risk factors for radiotherapeutic effect in patients with advanced esophageal cancer(P<0.01).ROC curve analysis showed that serum TGF-β1,TSP1 and SCCA levels alone and in combination before radiotherapy were effective in predicting the radiotherapeutic effect of patients with advanced esophageal cancer.At 12-month follow-up,the survival rate of the effective group was 89.77%(79/88),which was higher than that of the ineffective group[66.67%(14/21)],showing significant differences(P<0.01).Conclusion There is a close relationship of radiotherapeutic effect with clinical stage and serum levels of TGF-β1,TSP1 and SCCA in patients with advanced esophageal cancer before radiotherapy.In clinical practice,it is possible to predict radiotherapeutic effect of patients with advanced esophageal cancer by detecting serum levels of TGF-β1,TSP1 and SCCA before radiotherapy,which can help guide the formulation of clinical treatment plans,prevent delayed treatment,and improve survival rates of patients.