联合检测Gal-1、LOXL2对宫颈癌根治术后复发转移的预测价值

Predictive value of combined detection of Gal-1 and LOXL2 for recurrence and metastasis of cervical cancer after radical surgery

摘要:

目的 探究联合检测半乳糖凝集素-1（Gal-1）、赖氨酰氧化酶样蛋白2（LOXL2）对宫颈癌根治术后复发转移的预测价值。方法 前瞻性选取2016年5月—2021年5月在聊城市第二人民医院行根治术的110例宫颈癌患者作为研究组，另随机选取同期在该院健康体检的95例女性作为对照组。两组均行Gal-1、LOXL2检查。研究组术后进行3年的随访，根据术后有无复发转移分为复发组（31例）和未复发组（79例）。采用多因素逐步Logistic回归模型分析复发转移发生的影响因素，采用受试者工作特征（ROC）曲线评估Gal-1、LOXL2对宫颈癌根治术后复发转移的预测价值。结果 研究组与对照组年龄、体质量指数（BMI）、吸烟史、饮酒史比较，差异均无统计学意义（P >0.05）。研究组Gal-1、LOXL2水平高于对照组（P <0.05）。复发组与未复发组年龄、BMI、吸烟史、饮酒史、病理类型、分化程度比较，差异均无统计学意义（P >0.05）。复发组Ⅱ期占比、肿瘤最大径、浸润≥1/2肌层占比、淋巴结转移占比、Gal-1、LOXL2水平高于对照组（P <0.05）。多因素逐步Logistic回归分析结果显示，临床分期［O^R=2.437（95% CI：1.261，4.708）］、淋巴结转移［O^R=1.894（95% CI：1.237，2.897）］、Gal-1水平［O^R=4.731（95% CI：1.762，12.704）］、LOXL2水平［O^R=2.932（95% CI：1.677，5.126）］是复发转移发生的危险因素（P <0.05）。ROC曲线分析结果显示，Gal-1、LOXL2及两者联合预测患者术后复发转移的敏感性分别为67.70%（95% CI：0.452，0.839）、77.40%（95% CI：0.484，0.871）、90.30%（95% CI：0.839，0.968），特异性分别为77.20%（95% CI：0.532，0.873）、73.40%（95% CI：0.516，0.861）、70.90%（95% CI：0.456，0.835），曲线下面积分别为0.786（95% CI：0.681，0.892）、0.792（95% CI：0.688，0.896）、0.902（95% CI：0.828，0.975）。结论 宫颈癌患者血清Gal-1、LOXL2高表达，是根治术后发生复发转移的影响因素，联合测定Gal-1、LOXL2水平可较好地预测其发生风险。

Abstract:

Objective To investigate the predictive value of galectin-1 (Gal-1) and lysyl oxidase-like 2 (LOXL2) for recurrence and metastasis of cervical cancer after radical surgery.Methods A total of 110 patients with cervical cancer who underwent radical surgery at Liaocheng Second People's Hospital from May 2016 to May 2021 were prospectively selected as the study group, and 95 women who underwent health checkup in the hospital during the same period were randomly selected as the control group. All subjects underwent Gal-1 and LOXL2 tests. The study group was followed up for 3 years, and was divided into the recurrence group (31 cases) and the non-recurrence group (79 cases) based on postoperative recurrence and metastasis. Multivariable analysis was perfomred to determine the factors affecting the recurrence and metastasis, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of Gal-1 and LOXL2 for recurrence and metastasis of cervical cancer after radical surgery.Results There were no statistically significant differences between the study and control groups in terms of age, body mass index (BMI), smoking rate, and alcohol consumption rate (P > 0.05). The Gal-1 and LOXL2 levels in the study group were higher than those in the control group (P < 0.05). There were no statistically significant differences between the occurrence and non-occurrence groups in terms of age, BMI, smoking history, alcohol consumption history, pathological type, and degree of differentiation (P > 0.05). The occurrence group had a higher proportion of stage II tumors, larger tumor maximum diameter, higher proportion of ≥1/2 myometrial invasion, higher proportion of lymph node metastasis, and higher levels of Gal-1 and LOXL2 compared to the non-occurrence group (P < 0.05). Multivariable Logistic regression analysis revealed that advanced clinical stage [O^R = 2.437 (95% CI: 1.261, 4.708) ], lymph node metastasis [O^R = 1.894 (95% CI: 1.237, 2.897) ], and higher levels of Gal-1 [O^R = 4.731 (95% CI: 1.762, 12.704) ] and LOXL2 [O^R = 2.932 (95% CI: 1.677, 5.126) ] were risk factors for recurrence and metastasis (P < 0.05). ROC curve analysis demonstrated that the sensitivities of Gal-1, LOXL2 and their combination in predicting postoperative recurrence and metastasis of patients were 67.70% (95% CI: 0.452, 0.839), 77.40% (95% CI: 0.484, 0.871), and 90.30% (95% CI: 95%CI), with the specificities being 77.20% (95% CI: 0.532, 0.873), 73.40% (95% CI: 0.516, 0.861) and 70.90% (95% CI: 0.456, 0.835), and the areas under curves being 0.786 (95% CI: 0.681, 0.892), 0.792 (95% CI: 0.688, 0.896) and 0.902 (95% CI: 0.828, 0.975).Conclusion The high expression of Gal-1 and LOXL2 in the serum of patients with cervical cancer is an influencing factor for recurrence and metastasis after radical surgery. The combined determination of Gal-1 and LOXL2 levels can better predict the risk of recurrence and metastasis.