摘要
目的:探讨血清甘胆酸(CG)、总胆汁酸(TBA)、微小RNA-192(mi R-192)与直肠癌的关联性,并分析各指标预测直肠癌经肛联合经腹全直肠系膜切除(TME)术后早期复发的效能。方法:选取2019年1月—2020年4月收治的100例直肠癌患者(直肠癌组)、60例直肠良性疾病患者(良性组)及60例健康人群(对照组),比较3组血清CG、TBA、mi R-192水平,采用Logistic回归方程分析直肠癌的相关影响因素,直肠癌组均行经肛联合经腹TME术治疗,术后随访6个月,统计术后早期复发情况,比较复发与未复发患者一般资料及术后2、4周血清CG、TBA、mi R-192水平变化,采用受试者工作特征曲线(ROC)及曲线下面积(AUC)分析各指标预测直肠癌术后早期复发的效能。结果:直肠癌组CG、TBA高于良性组和对照组,mi R-192低于良性组和对照组(P<0.05);CG、TBA、mi R-192均为发生直肠癌的影响因素(P<0.05);直肠癌术后复发患者术后2周、4周的CG、TBA高于未复发患者,mi R-192低于未复发患者(P<0.05);术后4周CG、TBA、mi R-192预测直肠癌术后早期复发的AUC大于术后2周,其中术后4周CG预测的AUC最大,为0.849,截断值预测敏感度、特异度分别为75.00%、85.71%。结论:血清CG、TBA、mi R-192水平异常变化与直肠癌的发生存在显著关联性,术后检测各指标水平可辅助临床预测直肠癌术后早期复发。
Objective: To investigate the relationship between serum cholyglycine(CG), total b ile acid(TBA), micro RNA-192(mi R-192) and rectal cancer, and to analyze the efficacy of various indicators in predicting the early recurrence of rectal cancer after transanal combined transabdominal total mesorectal excision(TME). Methods: From January 2019 to April 2020, 100 patients with rectal cancer(rectal cancer group), 60 patients with rectal benign diseases(benign group) and 60healthy people(control group) were selected from our hospital. The serum levels of CG, TBA, and mi R-192 were compared among the three groups, and the relevant influencing factors of rectal cancer were analyzed by Logistic regression equation. The rectal cancer group underwent transanal combined with transabdominal TME treatment, and was followed up for 6 months after surgery.The early postoperative recurrence was counted. The general data of patients with or without recurrence were compared, as well as serum CG, TBA and mi R-192 levels before surgery, 2 weeks after surgery, and 4 weeks after surgery. The receiver operating characteristic curve(ROC) and the area under the ROC(AUC) were used to analyze the efficacy of each index in predicting the early recurrence of rectal cancer after surgery. Results: CG and TBA of rectal cancer group were higher than those of benign group and control group, mi R-192 was lower than benign group and control group(P<0.05). CG, TBA, mi R-192 were all influencing factors of rectal cancer(P<0.05). The CG and TBA of patients with rectal cancer recurrence were higher than those without recurrence at 2and 4 weeks after operation, and mi R-192 was lower than those without recurrence(P<0.05). The area under the curve(AUC) of CG, TBA and mi R-192 predicting early postoperative recurrence of rectal cancer at 4 weeks after surgery was greater than that at 2 weeks after surgery. The AUC predicted by CG at 4 weeks after operation was the largest, which was 0.849. The predictive sensitivity and specificity of the cut-off value were 75.00% and 85.71%, respectively. Conclusion:Abnormal changes in serum CG, TBA, mi R-192 levels are significantly related to the occurrence of rectal cancer. Postoperative detection of the levels of various indicators can help clinical prediction of early postoperative recurrence of rectal cancer.
作者
郭成云
孙二峰
卢立成
GUO Cheng-yun;SUN Er-feng;LU Li-cheng(Department of Anorectal Surgery,Sanmenxia Central Hospital,Sanmenxia 472000,China;Department of Anorectal Surgery,Zhengzhou Central Hospital,Zhengzhou 450000,China)
出处
《中国现代普通外科进展》
CAS
2023年第1期18-23,共6页
Chinese Journal of Current Advances in General Surgery
基金
河南省医学科技攻关计划(联合共建)项目(LHGJ20190511)。
