十二指肠肿瘤切除术围手术期患者血清胃蛋白酶 和热休克蛋白70 水平的变化及其临床意义

Changes of levels of serum pepsin and heat shock protein 70 during perioperative period of duodenal tumor resection and their clinical significance

摘要:

目的 探讨十二指肠肿瘤切除术围手术期患者血清胃蛋白酶和热休克蛋白70HSP70 水平的变化 及其临床意义。方法 选取42 例十二指肠恶性肿瘤患者作为研究对象。统计其肿瘤TNM 分期和2 年生存率， 比较不同TNM 分期和生存预后患者围手术期的血清胃蛋白酶Ⅰ、胃蛋白酶Ⅱ及HSP70 水平，分析其围手术 期血清胃蛋白酶Ⅰ、胃蛋白酶Ⅱ及HSP70 水平与TNM 分期和生存预后的关系以及其在患者生存预后预测中 的应用价值。结果 与术前比较，患者术后7 d 血清胃蛋白酶Ⅰ、胃蛋白酶Ⅱ及HSP70 水平降低（P <0.05）。 与Ⅰ期患者比较，Ⅱ、Ⅲ期患者围手术期清胃蛋白酶Ⅰ、胃蛋白酶Ⅱ及HSP70 水平升高（P <0.05）。与存活 患者比较，死亡患者围手术期血清胃蛋白酶Ⅰ、胃蛋白酶Ⅱ和HSP70 水平升高（P <0.05）。Logistic 分析结 果显示，十二指肠肿瘤切除术围手术期血清胃蛋白酶Ⅰ、胃蛋白酶Ⅱ和HSP70 水平与其TNM 分期和生存预 后相关（P <0.05）；ROC 曲线分析结果显示，十二指肠肿瘤切除术围手术期血清胃蛋白酶Ⅰ、胃蛋白酶Ⅱ及 HSP70 水平预测其生存预后的敏感性和特异性较高。结论 十二指肠肿瘤切除术患者治疗后血清胃蛋白酶和 HSP70 水平降低，且血清胃蛋白酶和HSP70 水平与TNM 分期和生存预后相关，可作为病情和预后评估的参 考指标。

Abstract:

Objective To investigate the changes of levels of serum pepsin and heat shock protein 70 (HSP70) during perioperative period of duodenal tumor resection and their clinical significance. Methods A total of 42 patients with duodenal malignancies were selected. Tumor stage and 2-year survival rate were collected. Serum pepsin I, pepsin Ⅱ and HSP70 levels in patients with different tumor stage and survival prognosis were compared. Relationship between serum pepsin I, pepsin Ⅱ and HSP70 levels and the tumor stage and survival prognosis were analyzed, and application value in predicting survival and prognosis of patients were analyzed. Results Compared with the preoperative, postoperative 7d serum pepsin I, pepsin Ⅱ and HSP70 levels were decreased (P < 0.05). Compared patients with stage Ⅰ, perioperative levels of serum pepsin I, pepsin Ⅱ and HSP70 in patients with stage Ⅱ and Ⅲ were increased (P < 0.05). And compared with the survival patients, perioperative serum pepsin I, pepsin Ⅱ and HSP70 levels in death patients were increased (P < 0.05). Logistic analysis showed that the levels of serum pepsin I, pepsin Ⅱ and HSP70 during perioperative period of duodenal tumor resection were correlated with TNM stage and survival prognosis (P < 0.05). ROC curve analysis showed high sensitivity and high specificity of levels of serum pepsin I, pepsin Ⅱ and HSP70 levels during perioperative period of duodenal tumor resection to predict the prognosis. Conclusions Levels of serum pepsin and HSP70 decrease after duodenal tumor resection, and are correlated with tumor stage and survival prognosis, and may be used as reference index for evaluating the state of illness and prognosis.