天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (6): 622-626.doi: 10.11958/20212066

• 临床研究 • 上一篇    下一篇

食管癌患者血清IGFBP-2的表达与营养状态及预后的关系

白成云，李忠诚，李文军，刘洋   

  1. 青海大学附属医院胸外科（邮编810001）
  • 收稿日期:2021-09-06 修回日期:2022-02-09 出版日期:2022-06-15 发布日期:2023-12-20
  • 通讯作者: 白成云 E-mail:baicy86qh@163.com
  • 基金资助:
    青海省2019年卫生健康科研课题（2019-wjzdx-60）；青海省科技厅项目（2019-SF-L2）

The expression of serum IGFBP-2 in patients with esophageal cancer and its relationship with nutritional status and prognosis

BAI Chengyun, LI Zhongcheng, LI Wenjun, LIU Yang   

  1. Department of Thoracic Surgery, the Affiliated Hospital of Qinghai University, Xining 810001, China
  • Received:2021-09-06 Revised:2022-02-09 Published:2022-06-15 Online:2023-12-20

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摘要： 摘要：目的　探讨血清胰岛素样生长因子结合蛋白-2（IGFBP-2）在食管癌患者中的表达及其与营养状态和预后的关系。方法　选取行手术及放（化）疗治疗的136例食管癌患者，采用酶联免疫吸附试验（ELISA）检测患者血清IGFBP-2的表达水平，分析其与患者临床病理特征、营养相关参数的关系。通过Kaplan-Meier生存曲线评估血清IGFBP-2表达对食管癌患者总生存期（OS）的影响，采用多因素Cox回归分析IGFBP-2食管癌患者预后的影响因素。结果　全组食管癌患者血清IGFBP-2水平中位数为302.52 μg/L，据此分为高表达组（68例）与低表达组（68例）。与低表达组相比，高表达组患者体质量减轻≥5%（χ2=6.814）、血清白蛋白＜35 g/L（χ2=23.702）、C反应蛋白≥10 mg/L（χ2=4.561）、格拉斯哥预后评分（GPS）1~2分（χ2=17.486）、预后营养指数（PNI）<50.8（χ2=51.883）的比例明显升高，外周血淋巴细胞绝对值下降（均P＜0.05）。生存分析显示，IGFBP-2高表达患者中位OS明显短于低表达组（22.0个月vs. 36.0个月，Log-rank χ2=5.037，P＜0.05）。多因素Cox回归分析发现，血清IGFBP-2高表达（HR=1.631，95%CI：1.064~2.940，P=0.025）与TNM分期Ⅲ~Ⅳ期（HR=1.851，95%CI：1.166~2.940，P=0.009）是影响食管癌患者预后的独立预测因素。结论　食管癌患者血清IGFBP-2表达升高提示患者营养不良，总体预后不佳。

关键词: 食管肿瘤, 胰岛素样生长因子结合蛋白质2, 营养状况, 预后

Abstract: Abstract: Objective　To explore the expression level of insulin-like growth factor binding protein-2 (IGFBP-2) and its correlations to nutritional status and the prognosis of esophageal cancer patients. Methods　A total of 136 esophageal cancer patients treated with surgical resection and chemotherapy/radiotherapy in our hospital were included in this study. The expression level of serum IGFBP-2 was detected by enzyme linked immunosorbent assay (ELISA), and its correlations to clinicopathological characteristics and nutritional parameters were further analyzed. Kaplan-Meier survival curve was plotted to evaluate the impact of serum IGFBP-2 expression on the overall survival (OS) of esophageal cancer patients. Moreover, the Cox multivariate regression analysis was used to determine the prognostic significance of serum IGFBP-2 level for esophageal cancer patients. Results　All patients were divided into the high expression (n=68) group and the low expression group (n=68) based on the median value (302.52 μg/L) of serum IGFBP-2 expression. Compared with the low expression group, patients with high expression of serum IGFBP-2 had a higher proportion of weight loss ≥ 5% (χ2= 6.814), serum albumin <35 g/L (χ2=23.702), C-reactive protein ≥10 mg/L　(χ2= 4.561), Glasgow prognostic score (GPS) 1-2 (χ2= 17.486) and prognostic nutritional index (PNI) <50.8 (χ2= 51.883), and a lower count of peripheral blood lymphocyte (P＜0.05). Kaplan-Meier curves showed that the median OS of patients with high IGFBP-2 expression was significantly shorter than that of patients with low IGFBP-2 expression (22.0 months vs. 36.0 months, Log-rank χ2=5.037，P＜0.05). The results of multivariate Cox analysis indicated that high serum IGFBP-2 expression (HR=1.631, 95%CI: 1.064-2.940, P=0.025) and tumor stage Ⅲ-Ⅳ (HR=1.851, 95%CI: 1.166-2.940, P=0.009) were independent prognostic factors for esophageal cancer patients. Conclusion　The elevated serum level of IGFBP-2 expression is an indicator of malnutrition status, suggesting a poor prognosis of esophageal cancer.

Key words: esophageal neoplasms, insulin-like growth factor binding protein 2, nutritional status, prognosis