血清血管生成素-2水平与进展期胃癌术后复发及预后的关系

目的 探讨进展期胃癌患者血清血管生成素-2(Ang-2)水平与术后复发及预后的关系.方法 采用ELISA 法检测85 例进展期胃癌患者根治术前、术后1 个月及30 位健康对照者血清Ang-2 水平;术后随访3 年,胃癌复发患者及未复发患者复查血清Ang-2 水平.分析影响术前血清Ang-2 水平升高的因素,探讨血清Ang-2 水平变化与术后复发及预后的关系.结果 进展期胃癌组术前血清Ang-2 水平显著高于正常对照组(345.3 ±141.8)μg/L vs.(187.4 ±32.7)μg/L,P ＜0.01],术后1 个月血清Ang-2 水平显著降低(P ＜0.01).术后复发组血清Ang-2 水平显著高于术后1 个月组和未复发组(288.7 ±97.8)μg/L vs.(210.5 ±63.4)μg/L,(231.1 ±68.2)μg/L,P ＜0.01].单因素分析显示术前血清Ang-2 水平升高与肿瘤大小、Borrmann 分型、分化程度、淋巴结转移率、浸润深度相关(P ＜0.05),而与肿瘤组织类型无关(P ＞0.05).Logistic 多因素回归分析显示肿瘤大小、分化程度、淋巴结转移、浸润深度是影响进展期胃癌术前血清Ang-2 水平升高的独立危险因素.术前高血清Ang-2 水平负面影响术后生存率和复发率.结论 进展期胃癌术前血清Ang-2 水平升高与多种重要肿瘤病理特征相关,可能是影响预后的重要因素,有助预后评价;术后血清Ang-2 水平变化有助监测术后复发.

Correlation between serum angiopoietin-2 levels and postoperative recurrence and prognosis in patients with advanced gastric cancer

Objective To investigate the correlation between serum angiopoietin-2（Ang-2）levels and postoperative recurrence and prognosis in the patients with advanced gastric cancer Methods The preoperative and 1 month postoperative serum Ang-2 levels in 85 patients with radical gastrectomy for advanced gastric cancer were measured by ELISA technique.The serum Ang-2 levels in 30 normal controls were also measured.The postoperative prognosis was followed-up,and the serum Ang-2 levels in the patients with recurred gastric cancer and the patients without recurred gastric cancer were repeatly measured.The factors that affected the preoperative serum Ang-2 levels were analyzed.The relation between the serum Ang-2 levels and postoperative recurrence and prognosis in the patients with advanced gastric cancer was investigated.Results The serum Ang-2 levels in advanced gastric cancer group were significantly higher than those in the normal controls（345.3±141.8）μg/L vs.（187.4±32.7）μg/L,P0.01]and were significantly dereased 1 month after the operation（P0.01）.The serum Ang-2 levels in the postoperative recurred gastric cancer group were significantly higher than those in the 1 month postoperation group and no recurrence gastric cancer group（288.7±97.8）μg/L vs.（210.5±63.4）μg/L,（231.1±68.2）μg/L,P0.01].Univariate analysis revealed that preoperative high serum Ang-2 levels were related with differentiated degree of the tumor tissue,Borrmann type,tumor size,lymph node metastasis ratio,depth of tumor invasion（P0.05）,but not related with the histological type（P0.05）.Multivariate logistic regression analysis revealed that differentiated degree of the tumor tissue,tumor size,lymph node metastasis,depth of tumor invasion were independent risk factors for the elevation of preoperative serum Ang-2 levels in the advanced gastric cancer.Elevated preoperative serum Ang-2 levels negatively affected the postoperative survival rate and recurrence rate.Conclusions Preoperative elevated serum Ang-2 levels is related with some important pathologic features in patients with advanced gastric cancer,and may be an important prognostic factor.Postoperative serum Ang-2 levels change is useful for monitoring of recurrence of advanced gastric cancer.