摘要
目的探讨血清热休克蛋白90α(Hsp90α)和人软骨糖蛋白-39(YKL-40)对恶性腹水(MA)患者生存状况的预测价值。方法收集2017年1月至2018年6月该院住院的良性腹水患者45例,MA患者105例。酶联免疫吸附法(ELISA)测定血清YKL-40水平,酶联免疫法测定Hsp90α水平。比较两组患者间Hsp90α和YKL-40水平差异,及其与MA临床资料的关系,采用Kaplan-Meier、Cox多因素回归分析MA患者的生存状况及影响因素。结果与良性腹水组比较,MA组Hsp90α和YKL-40显著升高(t=8.194、6.022,P<0.01);Hsp90α高值组与低值组的年龄、淋巴结转移、多发肿瘤、腹水癌胚抗原(CEA)差异有统计学意义(χ^2=5.453、4.421、12.299、6.635,P<0.05);YKL-40高值组与低值组的组织类型、分化程度、淋巴结转移、多发肿瘤、腹水CEA差异有统计学意义(χ^2=4.786、4.292、6.507、19.250、8.731,P<0.05);Cox多因素回归分析显示年龄、淋巴结转移、多发肿瘤、家族史、Hsp90α和YKL-40水平均是影响预后的独立危险因素(P<0.05)。Hsp90α的高值组和低值组的中位生存期分别为8.7、15.4周,平均生存时间分别为(9.49±3.73)、(16.13±6.63)周,两组比较差异具有统计学意义(P<0.05)。YKL-40高值组和低值组的中位生存期分别为9.90、12.50周,平均生存时间分别为(11.06±4.76)、(14.65±7.03)周,两组比较差异具有统计学意义(P<0.05)。结论血清Hsp90α和YKL-40水平在MA患者中表达增高,对患者的生存状况有一定预测价值。
Objective To investigate the predictive value of serum Hsp90αand YKL-40 in the survival status of patients with malignant ascites(MA).Methods A total of 45 cases of benign ascites and 105 cases of MA hospitalized from January 2017 to June 2018 were detected,YKL-40 was determined by enzyme-linked immunosorbent assay(ELISA)and Hsp90αwas determined by enzyme-linked immunosorbent assay.The differences of Hsp90αand YKL-40 levels between the two groups were compared,and the relationship between Hsp90α,YKL-40 levels and clinical MA data were analyzed.Kaplan-Meier and Cox multivariate regression analysis were used to analyze the survival status and influencing factors of MA patients.Results The serum levels of Hsp90αand YKL-40 were significantly elevated in the MA group compared with the benign ascites group(t=8.194,6.022,P<0.01).There were significant differences in age,lymph node metastasis,multiple tumors,and ascites carcinoembryonic antigen(CEA)between Hsp90αhigh-value group and low-value group(χ^2=5.453,4.421,12.299,6.635,P<0.05).There were significant differences in tissue type,degree of differentiation,lymph node metastasis,multiple tumors,and ascites CEA between YKL-40 high-value group and low-value group(χ^2=4.786,4.292,6.507,19.250,8.731,P<0.05).The Cox multivariate regression analysis showed that age,lymph node metastasis,multiple tumors,family history,levels of Hsp90αand YKL-40 were independent risk factors for prognosis(P<0.05).The median survival time of the Hsp90αhigh-value group and the Hsp90αlow-value group was 8.7 and 15.4 weeks,respectively,and the mean survival time was(9.49±3.73)and(16.13±6.63)weeks,respectively,and there were statistically significant differences between the two groups(P<0.05).The median survival time of the YKL-40 high-value group and the YKL-40 low-value group was 9.90 and 12.50 weeks,respectively,and the mean survival time was(11.06±4.76)and(14.65±7.03)weeks,respectively,and there were statistically significant differences between the two groups(P<0.05).Conclusion The levels of serum Hsp90αand YKL-40 are elevated in MA patients,and have predictive value for patients′survival status.
作者
吴金庆
周亚柏
王双平
王桂周
陆启峰
WU Jinqing;ZHOU Yabo;WANG Shuangping;WANG Guizhou;LU Qifeng(Department of Digestive Internal Medicine,Fuyang People's Hospital,Fuyang,Anhui 236000,China)
出处
《重庆医学》
CAS
2020年第10期1664-1668,共5页
Chongqing medicine
