摘要
目的探讨血清对氧磷酶1(PON1)联合白蛋白/球蛋白比值(AGR)对膀胱癌根治术后尿道复发的预测价值。方法选取接受膀胱癌根治术的183例患者为研究对象,根据随访期间的尿道复发情况将患者分为复发组和未复发组,比较两组术前血清PON1、AGR水平及临床病理特征,采用多因素logistic回归分析膀胱癌根治术后尿道复发的危险因素;通过绘制受试者工作特征(ROC)曲线,分析术前血清PON1、AGR水平对膀胱癌根治术后尿道复发的预测价值。结果随访期间3例失访,180例患者纳入研究,膀胱癌根治术后患者共有23例尿道复发,复发率12.78%。复发组术前血清PON1水平低于未复发组(P<0.05),复发组年龄、术前血清AGR水平高于未复发组(P<0.05),复发组肿瘤直径>3 cm、多发、临床分期T_(3a)~T_(4a)期、病理分级为高级别、侵犯前列腺、接受非原位可控尿道改道术患者占比均高于未复发组(P<0.05)。多因素logistic回归分析显示:年龄、肿瘤直径>3 cm、临床分期T_(3a)~T_(4a)期、病理分级为高级别、侵犯前列腺、接受非原位可控尿道改道术及术前血清低PON1水平、术前血清高AGR水平均是膀胱癌根治术后尿道复发的危险因素(P<0.05)。术前血清PON1、AGR单独及二者联合预测膀胱癌根治术后尿道复发的曲线下面积(AUC)分别为0.803、0.881、0.897。结论术前血清PON1水平降低和AGR水平升高均是膀胱癌根治术后尿道复发的危险因素,术前血清PON1和AGR可作为预测此类患者术后尿道复发的辅助指标。
Objective To evaluate the predictive value of serum serum paraoxonase 1(PON1)and albumin/globulin ratio(AGR)in bladder carcinoma urethral recurrence after radical cystectomy.Methods 183 patients who underwent radical bladder cancer surgery in our hospital were selected.According to the urethral recurrence during the follow-up period,the patients were divided into recurrence group and non-recurrence group.The preoperative serum PON1,AGR levels and clinicopathological features were compared between the two groups.Multivariate logistic regression analysis was used to analyze the risk factors of urethral recurrence after radical bladder cancer surgery.The predictive value of preoperative serum PON1 and AGR levels for urethral recurrence after radical bladder cancer surgery were analyzed by drawing receiver operating characteristic(ROC)curve.Results During the follow-up period,3 cases were lost to follow-up,and 180 patients were included in the study.A total of 23 patients had urethral recurrence after radical bladder cancer surgery,with a recurrence rate of 12.78%.The preoperative serum PON1 level in the recurrence group was significantly lower than that in the non-recurrence group(P<0.05).The age and preoperative serum AGR level in the recurrence group were significantly higher than those in non-recurrence group(P<0.05).The proportion of patients in the recurrence group with tumor diameter>3 cm,multiple occurrence,clinical stage T_(3a)-T_(4a),high-grade pathological grade,invasion of prostate and non-in situ controlled urethral diversion surgery were higher than those in the non-recurrence group(P<0.05).Multivariate Logistic regression analysis showed that age,tumor diameter>3 cm,clinical stage T_(3a)-T_(4a),high-grade pathological grade,invasion of prostate,non-in situ controlled urethral diversion surgery,preoperative serum low PON1 level and preoperative serum high AGR level were all risk factors for urethral recurrence after radical bladder cancer(P<0.05).The area under the ROC curve(AUC)of preoperative PON1 and
作者
盛永亮
吕双武
张扬
刘春辉
李志军
SHENG Yong-liang;LYU Shuang-wu;ZHANG Yang;LIU Chun-hui;LI Zhi-jun(Department of Urology Surgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan,China)
出处
《广东医学》
CAS
2022年第9期1150-1154,共5页
Guangdong Medical Journal
基金
河南省医学科技攻关计划项目(201601637)。
