血清趋化因子CXC配体13及趋化因子CXC受体5与老年进展期胃癌患者淋巴结转移的相关性

目的 观察老年进展期胃癌患者血清趋化因子CXC配体(CXCchemokine ligand,CXCL)13、趋化因子CXC受体(CXC chemokine receptor,CXCR)5水平变化,探讨CXCL13、CXCR5与老年进展期胃癌患者淋巴结转移的关系.方法 老年进展期胃癌患者89例为进展期胃癌组,其中发生淋巴...

Correlations of serum CXC chemokine ligand 13and CXC chemokine receptor type 5 with lymph node metastasis in elderly patients with advanced gastric cancer

Objective To observe the changes of CXC chemokine ligand 13(CXCL13)and CXC chemokine receptor type 5(CXCR5)levels in elderly patients with advanced gastric cancer,and to investigate the correlations of CXCL13and CXCR5with lymph node metastasis in elderly patients with advanced gastric cancer.Methods In 89elderly patients with advanced gastric cancer(advanced gastric cancer group),there were 38patients with lymph node metastasis(metastasis group)and 51patients without lymph node metastasis(non-metastasis group),while another 80elderly patients with early gastric cancer in the same period were as early gastric cancer group.ELISA method was used to detect the levels of serum CXCL13and CXCR5in advanced gastric cancer group and early gastric cancer group,and the serum CXCL12and CXCR4levels were detected in advanced gastric cancer group.The clinical data as the age and sex ratio as well as the serum levels of CXCL13,CXCR5,CXCL12and CXCR4were compared between metastasis and non-metastasis groups.Multivariate logistic regression analysis was used to evaluate the influencing factors of lymph node metastasis in elderly patients with advanced gastric cancer.ROC was drawn to assess the values of serum CXCL13and CXCR5levels to the prediction of lymph node metastasis in elderly patients with advanced gastric cancer.Results The levels of CXCL13and CXCR5were higher in advanced gastric cancer group(0.190(0.177,0.198),0.243(0.231,0.264)μg/L)than those in early gastric cancer group(0.176(0.167,0.184),0.234(0.225,0.244)μg/L)(P<0.05).The levels of CXCL13,CXCR5and CXCL12were higher in metastasis group((0.203±0.052),(0.279±0.085),(2.03±0.53)μg/L)than those in non-metastasis group((0.176±0.050,(0.223±0.080),(1.65±0.31)μg/L)(P<0.05),the CXCR4level was lower in metastasis group((0.39±0.10)μg/L)than that in non-metastasis group((0.49±0.11)μg/L)(P<0.05),and there were no significant differences in the age,sex ratio,body mass index and NYHA cardiac function classification between two groups(P>0.05).The serum CXCL13(OR=1.180,95%CI:1.085-1.296,P<0.001),CXCR5(OR=1.302,95%CI:1.050-1.423,P=0.005),CXCL12(OR=1.113,95%CI:1.010-1.209,P=0.008)and CXCR4(OR=1.036,95%CI:1.009-1.225,P=0.016)were the influencing factors of lymph node metastasis in elderly patients with advanced gastric cancer.When the optimal cut-off value of serum CXCL13was 0.165μg/L,the AUCfor predicting lymph node metastasis in elderly patients with advanced gastric cancer was 0.820(95%CI:0.736-0.905,P<0.001),the sensitivity was 97.4%,and the specificity was 51.0%.When the optimal cut-off value of CXCR5was 0.203μg/L,the AUCfor predicting lymph node metastasis was 0.804(95%CI:0.716-0.893,P<0.001),the sensitivity was 94.7%,and the specificity was 52.9%.The AUCof CXCL13combined with CXCR5for predicting lymph node metastasis was 0.928(95%CI:0.870-0.985,P<0.001),the sensitivity was 97.4%,and the specificity was 64.7%.Conclusion The serum CXCL13and CXCR5levels increase in elderly patients with advanced gastric cancer,and both of them are associated with lymph node metastasis and have certain values to the prediction of the risk of lymph node metastasis.