血管瘤患儿血清Apelin、IGF-2、GLUT1水平与瘤体增生及复发的关系

doi:10.11958/20242337

天津医药 ›› 2025, Vol. 53 ›› Issue (4): 378-382.doi: 10.11958/20242337

血管瘤患儿血清Apelin、IGF-2、GLUT1水平与瘤体增生及复发的关系

闫陶然(), 田雨, 郭雪松()

山西省儿童医院（山西省妇幼保健院）整形烧伤科（邮编030001）

收稿日期:2024-12-24 修回日期:2025-03-17 出版日期:2025-04-15 发布日期:2025-04-17
通讯作者: ^△ E-mail：etyyzxk@hotmail.com
作者简介:闫陶然（1989），男，主治医师，主要从事血管瘤与脉管畸形方面研究。E-mail：yantaoran916@126.com
基金资助:
山西省卫生健康委员会科研课题(2022A153)

The correlation between serum Apelin, IGF-2 and GLUT1 levels with tumor proliferation and recurrence in children with hemangioma

YAN Taoran(), TIAN Yu, GUO Xuesong()

Department of Plastic Surgery and Burns, Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital), Taiyuan 030001, China

Received:2024-12-24 Revised:2025-03-17 Published:2025-04-15 Online:2025-04-17
Contact: ^△ E-mail：etyyzxk@hotmail.com

闫陶然, 田雨, 郭雪松. 血管瘤患儿血清Apelin、IGF-2、GLUT1水平与瘤体增生及复发的关系[J]. 天津医药, 2025, 53(4): 378-382.

YAN Taoran, TIAN Yu, GUO Xuesong. The correlation between serum Apelin, IGF-2 and GLUT1 levels with tumor proliferation and recurrence in children with hemangioma[J]. Tianjin Medical Journal, 2025, 53(4): 378-382.

摘要/Abstract

摘要：

目的探讨婴幼儿血管瘤（IH）患儿血清爱帕琳肽（Apelin）、胰岛素样生长因子-2（IGF-2）、葡萄糖转运蛋白1（GLUT1）与瘤体增生及普萘洛尔停药后复发的关系。方法选取126例IH患儿（IH组），根据病理结果分为增生期组74例和退化期组52例，同时选取56例血管畸形患儿为血管畸形组。酶联免疫吸附试验（ELISA）检测全部患儿入院次日血清Apelin、IGF-2、GLUT1水平。IH患儿均予普萘洛尔治疗3个月。根据随访结果，将IH患儿分为复发组43例和未复发组83例。比较不同组患儿血清Apelin、IGF-2、GLUT1水平；多因素Logistic回归分析IH患儿普萘洛尔停药后复发的危险因素；受试者工作特征（ROC）曲线分析血清Apelin、IGF-2、GLUT1水平对IH患儿普萘洛尔停药后复发的预测价值。结果与血管畸形组比较，IH组患儿血清Apelin、IGF-2、GLUT1水平升高（P<0.05）；相较于退化期组，增生期组患儿血清Apelin、IGF-2、GLUT1水平升高（P<0.05）；复发组患儿血清Apelin、IGF-2、GLUT1水平高于未复发组（P<0.05）；Apelin、IGF-2、GLUT1水平升高，治疗后血管瘤分级Ⅰ—Ⅱ级是IH患儿普萘洛尔停药后复发的独立危险因素（P<0.05）；血清Apelin、IGF-2、GLUT1水平联合预测IH复发的曲线下面积优于单独预测（P<0.05）。结论 IH患儿血清Apelin、IGF-2、GLUT1水平升高，可作为预测患者瘤体增生及普萘洛尔停药后复发的血清学指标。

关键词: 血管瘤, 爱帕琳肽, 胰岛素样生长因子Ⅱ, 葡萄糖转运体1型, 普萘洛尔, 复发

Abstract:

Objective To investigate the relationship between serum endogenous ligand (Apelin), insulin-like growth factor-2 (IGF-2) glucose transporter 1 (GLUT1) and tumor hyperplasia and recurrence after withdrawal propranolol in infantile hemangioma (IH) children. Methods A total of 126 IH patients were selected and divided into the proliferative phase group (74 cases) and the involuting phase group (52 cases) based on the pathological results. Meanwhile, 56 patients with vascular malformations were selected as the vascular malformation group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of Apelin, IGF-2 and GLUT1 on the day after admission. All IH patients were treated with propranolol for 3 months. According to the follow-up results, IH patients were divided into the recurrence group (43 cases) and the non-recurrence group (83 cases). Serum levels of Apelin, IGF-2 and GLUT1 were compared between different groups of patients. Multivariate Logistic regression analysis was used to analyze risk factors for recurrence after propranolol discontinuation in IH patients. The prediction value of serum Apelin, IGF-2 and GLUT1 levels for recurrence after propranolol discontinuation in IH patients was analyzed by receiver operating characteristic curve (ROC). Results Compared with the vascular malformation group, serum levels of Apelin, IGF-2 and GLUT1were increased in the IH group (P<0.05). Compared with the degenerative group, serum levels of Apelin, IGF-2 and GLUT1 were increased in the proliferative group (P<0.05). Serum levels of Apelin, IGF-2 and GLUT1 were significantly higher in the recurrence group than those in the non-recurrence group (P<0.05). The increased Apelin, IGF-2 and GLUT1, and hemangioma grade I -II after treatment were independent risk factors for recurrence after withdrawal of propranolol in children with IH (P<0.05). The area under the curve (AUC) of Apelin, IGF-2 and GLUT1 combined predicted IH recurrence was better than that of simple prediction (P<0.05). Conclusion The increased serum levels of Apelin, IGF-2 and GLUT1 in IH patients can be used as serum indicators to predict tumor hyperplasia and recurrence after propranolol withdrawal in patients.

Key words: hemangioma, Apelin, insulin-like growth factor Ⅱ, glucose transporter type 1, propranolol, recurrence

中图分类号:

R732.2

图/表 7

参考文献 25

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组别	n	Apelin/（ng/L）	IGF-2/（μg/L）	GLUT1/（μg/L）
血管畸形组	56	103.64±10.73	6.38±0.65	7.36±0.78
IH组	126	126.16±12.78	7.78±0.78	8.70±0.89
t		11.503^＊＊	11.737^＊＊	9.726^＊＊

组别	n	Apelin/（ng/L）	IGF-2/（μg/L）	GLUT1/（μg/L）
血管畸形组	56	103.64±10.73	6.38±0.65	7.36±0.78
IH组	126	126.16±12.78	7.78±0.78	8.70±0.89
t		11.503^＊＊	11.737^＊＊	9.726^＊＊

组别	n	Apelin/（ng/L）	IGF-2/（μg/L）	GLUT1/（μg/L）
退化期组	52	118.39±12.49	7.27±0.74	8.04±0.84
增生期组	74	131.62±13.85	8.13±0.85	9.16±0.98
t		5.494^＊＊	5.892^＊＊	6.691^＊＊

组别	n	Apelin/（ng/L）	IGF-2/（μg/L）	GLUT1/（μg/L）
退化期组	52	118.39±12.49	7.27±0.74	8.04±0.84
增生期组	74	131.62±13.85	8.13±0.85	9.16±0.98
t		5.494^＊＊	5.892^＊＊	6.691^＊＊

组别		n	年龄/月		性别
组别		n	年龄/月		男		女
未复发组		83	5.13±0.52		47（56.63）		36（43.37）
复发组		43	5.19±0.53		26（60.47）		17（39.53）
χ²或t			0.610		0.171
组别	肿瘤面积					肿瘤分布模式
组别	≥5 cm²			<5 cm²		节段性		非节段性
未复发组	41（49.40）			42（50.60）		45（54.22）		38（45.78）
复发组	24（55.81）			19（44.19）		26（60.47）		17（39.53）
χ²	0.467					0.450
组别	治疗时间					治疗后分级
组别	≥6个月			<6个月		Ⅰ—Ⅱ级		Ⅲ—Ⅳ级
未复发组	49（59.04）			34（40.96）		28（33.73）		55（66.27）
复发组	18（41.86）			25（58.14）		29（67.44）		14（32.56）
χ²	3.356					12.991^＊＊

血管瘤患儿血清Apelin、IGF-2、GLUT1水平与瘤体增生及复发的关系

The correlation between serum Apelin, IGF-2 and GLUT1 levels with tumor proliferation and recurrence in children with hemangioma

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组别	n	Apelin/（ng/L）	IGF-2/（μg/L）	GLUT1/（μg/L）
未复发组	83	120.68±12.65	7.44±0.75	8.32±0.85
复发组	43	136.73±14.02	8.42±0.89	9.42±0.98
t		6.506^＊＊	6.518^＊＊	6.533^＊＊

自变量	β	SE	Waldχ²	P	OR	OR95%CI
Apelin	0.991	0.274	13.072	0.001	2.693	1.574~4.608
IGF-2	1.010	0.281	12.913	<0.001	2.745	1.583~4.761
GLUT1	1.094	0.302	13.129	<0.001	2.987	1.653~5.399
治疗后IH分级	1.466	0.523	10.467	0.001	4.654	1.872~11.695
常数项	-10.764	2.176	21.642	<0.001	0.000

指标	敏感度	特异度	截断值	AUC	95%CI	约登指数
Apelin	0.837	0.843	133.93 ng/L	0.886	0.887~0.936	0.681
IGF-2	0.721	0.916	8.20 ng/L	0.891	0.817~0.935	0.637
GLUT1	0.814	0.892	9.03 μg/L	0.913	0.849~0.956	0.706
联合	0.899	0.948		0.963	0.913~0.988	0.848

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