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中华普通外科学文献(电子版)

中华普通外科学文献(电子版) ›› 2020, Vol. 14 ›› Issue (04) : 290 -293. doi: 10.3877/cma.j.issn.1674-0793.2020.04.012

所属专题： 文献；

论著

血清可溶性OX40配体与晚期胃癌生存期的关系研究
刘芳1, 姜兰斌1, 汪亮1, 牛彦锋2, 肖勇2, 张万里2,†()   
  1. 1. 430015　武汉，武汉市红十字会医院（武汉市第十一医院）检验科
    2. 430022　武汉，华中科技大学同济医学院附属协和医院消化肿瘤外科
  • 收稿日期:2019-11-06 出版日期:2020-08-01
  • 通信作者: 张万里
  • 基金资助:
    湖北省自然科学基金项目(WJ2015MB075)

Study on the relationship between serum soluble OX40 ligand and the survival of advanced gastric cancer patients

Fang Liu1, Lanbin Jiang1, Liang Wang1, Yanfeng Niu2, Yong Xiao2, Wanli Zhang2,†()   

  1. 1. Department of Clinical Laboratory, Wuhan Red Cross Hospital, Wuhan 430015, China
    2. Department of Abdominal Tumor Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
  • Received:2019-11-06 Published:2020-08-01
  • Corresponding author: Wanli Zhang
  • About author:
    Corresponding author: Zhang Wanli, Email:
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引用本文：

刘芳, 姜兰斌, 汪亮, 牛彦锋, 肖勇, 张万里. 血清可溶性OX40配体与晚期胃癌生存期的关系研究[J/OL]. 中华普通外科学文献(电子版), 2020, 14(04): 290-293.

Fang Liu, Lanbin Jiang, Liang Wang, Yanfeng Niu, Yong Xiao, Wanli Zhang. Study on the relationship between serum soluble OX40 ligand and the survival of advanced gastric cancer patients[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(04): 290-293.

目的

探讨晚期胃癌患者血清可溶性OX40配体（sOX40L）水平与生存期的关系，为胃癌免疫治疗提供思路。

方法

选取武汉市红十字会医院和华中科技大学同济医学院附属协和医院2015年1月至2017年5月收治的115例晚期胃癌患者为观察组，同期健康体检者91名为对照组。ELISA法检测两组血清sOX40L水平，Kaplan-Meier曲线分析sOX40L水平与晚期胃癌患者生存时间的关系，再行危险因素的Cox回归分析。

结果

观察组sOX40L水平高于对照组（P<0.05），其中高水平组（sOX40L≥20.58 ng/L）58例，低水平组（sOX40L<20.58 ng/L）57例，sOX40L水平与患者TNM分期、淋巴结转移、肝转移有关（P<0.05）。高水平组的中位总生存时间为6.65个月（95% CI：5.89~7.42），短于低表达组的9.47个月（95% CI：8.59~10.36），差异有统计学意义（P< 0.001）。年龄≥60岁、sOX40L高表达、TNM Ⅳ期、淋巴结转移、肝转移均是晚期胃癌不良预后的独立危险因素（P<0.05）。

结论

sOX40L在晚期胃癌患者血清中呈高表达，其水平与TNM分期、淋巴结转移、肝转移有关，是胃癌患者不良预后的独立危险因素。

关键词: 胃肿瘤, OX40配体, 危险因素, 生存分析
Objective

To investigate the relationship between serum soluble OX40 ligand (sOX40L) and survival time in patients with advanced gastric cancer and to provide basis for immunotherapy of gastric cancer.

Methods

From January 2015 to May 2017, 115 patients with advanced gastric cancer admitted to Wuhan Red Cross Hospital and Union Hospital of Tongji Medical College were selected as the observation group, and 91 healthy persons in the same period were in the control group. The level of serum sOX40L in two groups was detected by ELISA, Kaplan-Meier curve was used to analyze the relationship between the level of sOX40L and survival time of patients, COX regression analysis was used for risk factors of advanced gastric cancer.

Results

The level of sOX40L in the observation group was higher than that in the control group (P<0.05). There were 58 cases in high level group (sOX40L ≥20.58 ng/L), 57 cases in low level group (sOX40L < 20.58 ng/L), the level of sOX40L was related to TNM stage, lymph node metastasis and liver metastasis (P<0.05). The median total survival time of high level group was 6.65 months (95% CI: 5.89-7.42), which was shorter than 9.47 months of low level group (95% CI: 8.59-10.36), the difference was statistically significant (P<0.001). Age ≥60 years old, high expression of sOX40L, TNMⅣ stage, lymph node metastasis and liver metastasis were independent risk factors for poor prognosis of advanced gastric cancer.

Conclusions

sOX40L is highly expressed in the serum of patients with advanced gastric cancer, its level is related to TNM stage, lymph node metastasis and liver metastasis. It is an independent risk factor for poor prognosis of patients with gastric cancer.

Key words: Stomach neoplasms, OX40 ligand, Risk factors, Survival analysis
表1 不同sOX40L水平的晚期胃癌患者临床病理特征比较
组别 例数 性别(例) 年龄(岁)a 体质指数(kg/m2)a TNM分期[例(%)] 淋巴结转移[例(%)] 肝转移[例(%)]
男 女 Ⅲ Ⅳ 有 无 有 无
高水平组 58 31 27 53.58±6.74 24.02±4.25 15(25.86) 43(74.14) 41(70.69) 17(29.31) 36(62.07) 22(37.93)
低水平组 57 33 24 52.31±5.87 23.47±3.54 29(50.88) 28(49.12) 27(47.37) 30(52.63) 18(31.58) 39(68.42)
统计值 ? 0.230 1.077 0.753 7.615 6.470 10.730
P值 ? 0.631 0.284 0.453 0.006 0.011 0.001
图1 sOX40L水平与晚期胃癌患者总生存时间的关系
表2 影响115例晚期胃癌患者预后的因素分析
变量 单因素分析 多因素分析
HR 95%置信区间 P值 HR 95%置信区间 P值
性别（男vs女） 2.136 1.136~4.015 0.095 — — —
年龄（<60岁 vs ≥60岁） 1.649 1.152~2.360 0.021 1.248 0.944~1.651 0.033
体质指数（<24 kg/m2 vs ≥24 kg/m2） 2.604 2.155~3.146 0.315 — — —
sOX40L表达（高水平vs低水平） 1.828 1.256~2.660 <0.001 1.655 1.204~2.275 <0.001
TNM分期（Ⅲ期 vs Ⅳ期） 3.231 1.809~5.769 <0.001 2.125 1.162~3.888 0.014
淋巴结转移（有vs无） 5.893 2.703~12.848 <0.001 2.742 1.186~6.340 0.018
肝转移（有vs无） 3.872 2.341~6.405 <0.001 3.093 1.762~5.431 <0.001
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