食管癌患者血清TM4SF1、KLF5、SOX3水平与预后的关系

doi:10.11958/20253552

摘要/Abstract

摘要：

目的探讨食管癌（EC）患者血清四次跨膜蛋白1（TM4SF1）、Kruppel样因子5（KLF5）、SRY-box转录因子3（SOX3）水平与预后的关系。方法纳入EC患者120例作为观察组，按病情程度分为早期组（73例）和中期组（47例），按术后1年预后分为预后良好组（77例）和预后不良组（43例）；另取120例同期健康体检者为对照组。酶联免疫吸附试验检测血清TM4SF1、KLF5、SOX3水平，分析预后影响因素及受试者工作特征（ROC）曲线评估价值。结果观察组血清三项指标显著高于对照组（P<0.05）。中期组高于早期组（P<0.05）。预后不良组淋巴结转移占比及血清三项指标均高于预后良好组（均P<0.05）。三项指标及淋巴结转移为EC预后的影响因素（P<0.05）。三者联合预测EC预后曲线下面积（AUC）为0.963（95%CI：0.912~0.989），优于单独预测（Z_{三者联合-TM4SF1}=3.229、Z_{三者联合-KLF5}=3.122、Z_{三者联合-SOX3}=2.696，均P<0.01）。结论 EC患者血清TM4SF1、KLF5、SOX3水平升高，与不良预后有关，三项指标联合检测可提升预后评估效能。

关键词: 食管肿瘤, 预后, 四跨膜蛋白质类, Kruppel样转录因子类, SOX转录因子类

Abstract:

Objective To investigate the relationship between serum levels of transmembrane 4 L six family member 1 (TM4SF1), Kruppel-like factor 5 (KLF5), SRY-box transcription factor 3 (SOX3) and prognosis in patients with esophageal cancer (EC). Methods A total of 120 patients with EC were enrolled as the observation group, and they were divided into the early group (73 cases) and the middle group (47 cases) according to the degree of disease. Patients were also divided into the good prognosis group (77 cases) and the poor prognosis group (43 cases) according to the prognosis of 1 year after operation. Another 120 healthy subjects who underwent physical examination in the same period were selected as the control group. Serum levels of TM4SF1, KLF5 and SOX3 were detected by ELISA. The prognostic factors and the evaluation value of receiver operating characteristic (ROC) curve were analyzed. Results Serum levels of the three indicators were significantly higher in the observation group than those in the control group (P<0.05). The levels in the middle-stage group were higher than those in the early-stage group (P<0.05). The proportion of lymph node metastasis and serum levels of the three indicators were significantly higher in the poor prognosis group than those in the favorable prognosis group (all P<0.05). The three indicators and lymph node metastasis were independent prognostic factors for EC (P<0.05). The AUC of the combined detection of the three indicators for predicting the prognosis of EC was 0.963 (95%CI：0.912-0.989), which was superior to that of single detection (Z _{combination-TM4SF1}=3.229, Z_{combination-KLF5}=3.122, Z _{combination-SOX3}=2.696, all P<0.01). Conclusion Serum levels of TM4SF1, KLF5 and SOX3 are elevated in EC patients, which are associated with poor prognosis. Combined detection of the three indicators can improve the efficacy of prognostic evaluation in EC patients.

Key words: esophageal neoplasms, prognosis, tetraspanins, Kruppel-like transcription factors, SOX transcription factors

中图分类号:

R735.1

图/表 6

参考文献 24

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组别	TM4SF1/（mg/L）	KLF5/（μg/L）	SOX3/（μg/L）
对照组	91.14±10.05	5.08±0.69	0.67±0.12
观察组	132.99±18.61	8.13±2.03	2.08±0.50
t	21.685^＊＊	15.594^＊＊	30.049^＊＊

组别	TM4SF1/（mg/L）	KLF5/（μg/L）	SOX3/（μg/L）
对照组	91.14±10.05	5.08±0.69	0.67±0.12
观察组	132.99±18.61	8.13±2.03	2.08±0.50
t	21.685^＊＊	15.594^＊＊	30.049^＊＊

组别	n	TM4SF1/（mg/L）	KLF5/（μg/L）	SOX3/（μg/L）
早期组	73	121.26±11.03	6.96±0.80	1.79±0.30
中期组	47	151.22±12.13	9.96±2.03	2.53±0.41
t		13.968^＊＊	9.689^＊＊	11.377^＊＊

组别	n	TM4SF1/（mg/L）	KLF5/（μg/L）	SOX3/（μg/L）
早期组	73	121.26±11.03	6.96±0.80	1.79±0.30
中期组	47	151.22±12.13	9.96±2.03	2.53±0.41
t		13.968^＊＊	9.689^＊＊	11.377^＊＊

组别	n		性别（男/女）		年龄/岁		肿瘤分期				分化程度			肿瘤类型
组别	n		性别（男/女）		年龄/岁		Ⅰ期		Ⅱ—Ⅲ期		中高分化	低分化		鳞癌		腺癌
预后良好组	77		48/29		56.36±7.93		42（54.55）		35（45.45）		51（66.23）	26（33.77）		40（51.95）		37（48.05）
预后不良组	43		26/17		55.88±7.48		19（44.19）		24（55.81）		23（53.49）	20（46.51）		25（58.14）		18（41.86）
χ²或t			0.041		0.324		1.185				1.896			0.426
组别		肿瘤位置				淋巴结转移				TM4SF1/（mg/L）			KLF5/（μg/L）		SOX3/（μg/L）
组别		上胸段		中下胸段		有		无		TM4SF1/（mg/L）			KLF5/（μg/L）		SOX3/（μg/L）
预后良好组		32（41.56）		45（58.44）		24（31.17）		53（68.83）		125.06±14.47			7.29±1.03		1.87±0.35
预后不良组		24（55.81）		19（44.19）		32（74.42）		11（25.58）		147.19±16.75			9.63±2.48		2.45±0.51
χ²或t		2.253				20.737^＊＊				7.585^＊＊			5.896^＊＊		7.490^＊＊