摘要
目的 比较不同临床分期胃腺癌患者的血浆脂肪酸占比,探讨差异脂肪酸对胃腺癌临床分期的预测效能。方法 选择行开放或微创胃腺癌根治性切除手术并经术后病理证实的胃腺癌患者40例,根据第8版美国癌症联合会(AJCC)的临床病理分期标准分为早期组(Ⅰ、Ⅱ期)21例、中晚期组(Ⅲ、Ⅳ期)19例。两组术前采用气相色谱法检测血浆脂肪酸占比,绘制两组间比较有差异的血浆脂肪酸预测临床分期的ROC曲线,计算曲线下面积(AUC),分析其预测价值。结果 按照长短来分:早期组血浆短链脂肪酸(SCFA)、中链脂肪酸(MCFA)、长链脂肪酸(LCFA)占比分别为0.13%(0.04%, 0.53%)、1.66%(0.16%, 2.41%)、96.93%(92.20%, 99.66%),中晚期组分别为0.49%(0.14%, 0.91%)、1.88%(0.24%, 3.52%)、95.64%(93.72%, 98.51%),两组比较差异均无统计学意义(P均>0.05)。按照结构来分:两组血浆饱和脂肪酸(SFA)、单不饱和脂肪酸(MUFA)、多不饱和脂肪酸(PUFA)及PUFA中的Ω-3多不饱和脂肪酸(Ω-3PUFA)、Ω-6多不饱和脂肪酸(Ω-6PUFA)占比比较差异均无统计学意义(P均>0.05);中晚期组血浆SFA中的棕榈酸(PA,C16:0)占比高于早期组,Ω-3PUFA的α-亚麻酸(ALA,C18:3n3)占比低于早期组(P均<0.05);两组其他血浆脂肪酸占比比较差异均无统计学意义(P均>0.05)。血浆PA、ALA单独及联合预测胃腺癌分期的AUC及95%CI分别为0.697(0.534~0.860)、0.703(0.528~0.878)、0.797(0.657~0.937),敏感度分别为58.0%、66.7%、63.2%,特异度分别为76.0%、84.2%、90.5%。结论 中晚期胃腺癌患者血浆PA占比高于早期患者、ALA占比低于早期患者,二者联合检测有助于术前判断胃腺癌患者的临床分期。
Objective To compare the proportion of plasma fatty acids in patients with gastric adenocarcinoma of different clinical stages and to explore the predictive value of differential fatty acids for the clinical stage of gastric adenocarcinoma.Methods Forty patients who underwent open or minimally invasive radical resection of gastric adenocarcinoma and were confirmed as gastric adenocarcinoma by postoperative pathology were selected.The patients were categorized into two groups based on the 8th edition of the American Joint Committee on Cancer(AJCC)clinicopathological staging criteria:the early stage group(stageⅠ/Ⅱ)of 21 cases and advanced stage group(stageⅢ/Ⅳ)of 19 cases.In the two groups,we used gas chromatography to detect the proportion of plasma fatty acids before surgery,drew the receiver operating characteristic(ROC)curve of plasma fatty acids that were relatively different between the two groups to predict clinical stage,calculated the area under the curve(AUC),and analyzed its predictive value.Results In light of length:the proportions of plasma short-chain fatty acids(SCFA),medium-chain fatty acids(MCFA)and long-chain fatty acids(LCFA)in the early group were 0.13%(0.04%,0.53%),1.66%(0.16%,2.41%)and 96.93%(92.20%,99.66%),respectively,and those in the advanced stage group were 0.49%(0.14%,0.91%),1.88%(0.24%,3.52%),and 95.64%(93.72%,98.51%),respectively;the differences between the two groups were not statistically significant(all P>0.05).In light of structure:there was no statistically significant differences in the proportion of plasma saturated fatty acids(SFA),monounsaturated fatty acids(MUFA),polyunsaturated fatty acids(PUFA)and omega-3 polyunsaturated fatty acids(Ω-3PUFA)or omega-6 polyunsaturated fatty acids(Ω-6PUFA)in PUFA between these two groups(all P>0.05);the proportion of palmitic acid(PA,C16:0)in plasma SFA of the advanced stage group was higher than that of the early group,and the proportion ofα-linolenic acid(ALA,C18:3n3)inΩ-3PUFA of the advanced stage group was lower than that in the early group(all P<0.05);there was no significant difference in the proportions of other plasma fatty acids between the two groups(all P>0.05).The AUC and 95%CI for plasma PA and ALA detection alone,as well as in combination,to predict gastric adenocarcinoma stage were 0.697(0.534-0.860),0.703(0.528-0.878),and 0.797(0.657-0.937),respectively,and the sensitivities were 58.0%,66.7%,and 63.2%,respectively,and the specificities were 76.0%,84.2%,and 90.5%,respectively.Conclusions The proportion of plasma PA is higher in gastric adenocarcinoma patients of the advanced stage than in the gastric adenocarcinoma patients of the early stage,while the proportion of ALA is lower.The combined detection of the two is helpful for the preoperative determination of the clinical stage of the patients with gastric adenocarcinoma.
作者
吴生为
丁潇东
毛伟征
WU Shengwei;DING Xiaodong;MAO Weizheng(Qingdao Clinical Medical College,Nanjing Medical University,Qingdao 266071,China)
出处
《山东医药》
CAS
2024年第11期36-40,共5页
Shandong Medical Journal
关键词
脂肪酸
临床分期
胃腺癌
棕榈酸
Α-亚麻酸
fatty acid
clinical staging
gastric adenocarcinoma,palmitic acid
α-linolenic acid
