血清LRG1、bFGF水平与上皮性卵巢癌患者临床病理特征及术后复发的关系

Association of serum LRG1 and bFGF levels with clinicopathological features and postoperative recurrence in epithelial ovarian cancer patients

摘要

目的 探究上皮性卵巢癌患者血清富亮氨酸α-2糖蛋白1(LRG1)、碱性成纤维细胞生长因子(bFGF)水平与其临床病理特征及术后复发的关系。方法 纳入2021年1月至2022年4月本院收治的136例上皮性卵巢癌患者为研究组,其中,56例术后检查又见癌灶即复发,80例术后无复发,另纳入136例同期体检健康人群为对照组。酶联免疫吸附法(ELISA)检测各组血清LRG1、bFGF表达水平,并以研究组表达量的均值分为高表达组和低表达组;K-M曲线分析LRG1、bFGF表达与患者术后复发的关系;Cox回归分析患者术后复发的影响因素;受试者工作特征(ROC)曲线分析预测术后复发的潜在价值。结果 与对照组相比,研究组血清LRG1、bFGF表达均升高(t=61.683、25.848,P<0.05)。LRG1、bFGF表达与患者淋巴结转移、肿瘤分化程度、FIGO分期、浸润深度有关(χ²=11.855、4.284、6.651、4.953,χ²=4.953、4.953、7.519、4.248,P<0.05)。上皮性卵巢癌患者术后2年复发率为41.18%。LRG1高表达组患者复发率53.03%显著高于低表达组的30.00%(χ²=6.002,P=0.014),bFGF高表达患者复发率50.72%显著高于低表达组的31.34%(χ²=6.179,P=0.013)。上皮性卵巢癌患者复发组血清LRG1、bFGF表达均高于无复发组(t=42.941、33.686,P<0.05)。LRG1(HR=2.358,95%CI:1.408~3.948)和bFGF(HR=1.633,95%CI:1.179~2.261)均为患者术后复发的危险因素(P<0.05)。血清LRG1表达预测术后复发的曲线下面积(AUC)为0.862;bFGF表达预测术后复发的AUC为0.825;二者联合预测的AUC为0.951,显著大于LRG1(Z=1.988,P=0.047)、bFGF(Z=2.561,P=0.010)单独预测的AUC。结论 上皮性卵巢癌患者血清LRG1、bFGF表达升高,与患者临床病理特征相关,为术后复发的危险因素,二者联合具有较高的上皮性卵巢癌患者术后复发预测价值。

Abstract

Objective To investigate the association of serum leucine-rich α-2-glycoprotein 1 (LRG1) and basic fibroblast growth factor (bFGF) levels with clinicopathological features and postoperative recurrence in epithelial ovarian cancer patients. Methods A total of 136 epithelial ovarian cancer patients treated at our hospital from January 2021 to April 2022 were enrolled as the study group (56 with postoperative recurrence, 80 recurrence-free), alongside 136 healthy controls. Serum LRG1 and bFGF levels were measured using enzyme linked immunosorbent assay (ELISA), with patients stratified into high/low expression groups based on mean values. Kaplan-Meier curves analyzed recurrence-free survival, Cox regression identified recurrence risk factors, and receiver operating characteristic (ROC) curves evaluated predictive value. Results Compared with the control group, the study group exhibited significantly elevated serum LRG1 and bFGF levels (t=61.683 and 25.848, respectively, P<0.05). LRG1 and bFGF expression demonstrated significant associations with lymph node metastasis, tumor differentiation grade, FIGO stage, and invasion depth (χ ²=11.855, 4.284, 6.651 and 4.953 for LRG1, χ ²=4.953, 4.953, 7.519 and 4.248 for bFGF, respectively, P<0.05). The 2-year postoperative recurrence rate of epithelial ovarian cancer patients was 41.18%. The recurrence rate of LRG1 high expression group was 53.03%, which was greatly higher than the low expression subgroup (30.00%, χ ²=6.002, P=0.014), while high-bFGF expression subgroup showed higher recurrence (50.72%) than its low-expression counterpart (31.34%, χ ²=6.179, P=0.013). Recurrence patients displayed higher serum LRG1 and bFGF levels than recurrence-free patients (t=42.941 and 33.686, respectively, P<0.05). Cox regression identified LRG1 (HR=2.358, 95%CI: 1.408-3.948) and bFGF (HR=1.633, 95%CI: 1.179-2.261) as independent risk factors for recurrence (P<0.05). The area under the curve (AUC) of serum LRG1 expression in predicting postoperative recurrence was 0.862, the bFGF is 0.825, the AUC predicted by the combination of the two was 0.951, which was greatly larger than LRG1 (Z=1.988, P=0.047), bFGF (Z=2.561, P=0.010). Conclusion Elevated serum LRG1 and bFGF levels in epithelial ovarian cancer patients are associated with aggressive clinicopathological features, serve as independent risk factors for postoperative recurrence, and demonstrate high predictive value for recurrence when combined.

关键词

上皮性卵巢癌 / 富亮氨酸α-2糖蛋白1 / 碱性成纤维细胞生长因子 / 临床病理特征 / 复发 / 预测

Key words

epithelial ovarian cancer / leucine-rich α-2 glycoprotein 1 / basic fibroblast growth factor / clinicopathological feature / recurrence / prediction

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基金资助

河北省邯郸市科学技术研究与发展计划项目(1622201051G2)