血清VEGF、MCP-1联合LncRNA XIST评估膀胱癌患者预后的价值

Value of serum VEGF,MCP-1 combined with LncRNA XIST in evaluating the prognosis of bladder cancer patients

摘要:

目的 探讨血清血管内皮生长因子（VEGF）、单核细胞趋化蛋白-1（MCP-1）联合长链非编码核糖核酸 X染色体失活特异性转录本（LncRNA XIST）评估膀胱癌患者预后的价值。方法 选择2018年6月至2019年6月本院收治的膀胱癌患者52例作为观察组，另选择同期接受体检的健康者43例作为对照组。两组分别于术前和体检时采集空腹状态外周静脉血，测定血清VEGF、MCP-1、LncRNA XIST水平，并进行相关性分析。术后随访1年，记录术后6个月和1年生存率。根据受试者工作特征（ROC）曲线计算血清VEGF、MCP-1、LncRNA XIST预测膀胱癌患者生存的截断值，将患者分为VEGF、MCP-1、LncRNA XIST高表达组和低表达组，分析不同亚组患者的生存情况。结果 观察组的血清VEGF、MCP-1、LncRNA XIST水平显著高于对照组，差异均有统计学意义（均P<0.01）。VEGF表达水平与膀胱癌患者肿瘤最大直径、T分期、分化程度、肿瘤分级、局部肿瘤浸润深度、远处转移、淋巴转移有相关性（P<0.05）；MCP-1表达水平与膀胱癌患者T分期、分化程度、肿瘤分级、局部肿瘤浸润深度有相关性（P<0.05）；LncRNA XIST表达水平与膀胱癌患者T分期、分化程度、肿瘤分级、局部肿瘤浸润深度、淋巴转移有相关性（P<0.05）。血清VEGF、MCP-1联合LncRNA XIST检查对膀胱癌诊断及预后的评估价值均高于单项和双项检查（AUC=0.909，95%CI：0.850～0.968；AUC=0.682，95%CI：0.538～0.826）。VEGF、MCP-1和LncRNA XIST高表达组的膀胱癌患者术后1年生存率显著低于低表达组，差异有统计学意义（P<0.05）。结论 血清VEGF、MCP-1联合LncRNA XIST检测有助于提高膀胱癌患者诊断率，且对预后具有一定评估价值。

Abstract:

Objective?? To investigate the value of serum vascular endothelial growth factor (VEGF), monocyte chemoattractant protein-1 (MCP-1) combined with long non coding RNA X-inactive specific transcript (LncRNA XIST) in evaluating the prognosis of bladder cancer patients. Methods?? Fifty-two patients with bladder cancer (observation group) and 43 healthy individuals (control group) in our hospital from June 218 to June 2019 were enrolled. Serum levels of VEGF, MCP-1 and LncRNA XIST were detected, and the correlation of those indexes was analyzed. Patients were followed up for 1 year, and the postoperative 6-month and 1-year survival rates were recorded.? The threshold values of serum VEGF, MCP-1 and LncRNA XIST in predicting the survival status were calculated using receiver operating characteristic (ROC) curve, thereafter, observation group was further divided into VEGF, MCP-1, and LncRNA XIST high and low expression groups, then the survival status of each subgroup was also analyzed.Results?? The levels of serum VEGF, MCP-1 and LncRNA XIST in patients with bladder cancer were significantly higher than those of healthy individuals (P<0.01). There was a significant positive correlation in serum VEGF, MCP-1 and LncRNA XIST expression levels within bladder cancer patients (P<0.05). VEGF expression was related to tumor maximum diameter, T stage, differentiation degree, tumor grade, local invasion depth, distant metastasis, and lymphatic metastasis in patients with bladder cancer (P<0.05); MCP-1 expression was related to T stage, differentiation degree, tumor grade and local invasion depth in patients with bladder cancer (P<0.05); LncRNA XIST expression was related to T stage, differentiation degree, tumor grade, local invasion depth, and lymphatic metastasis in patients with bladder cancer (P<0.05). The value of serum VEGF, MCP-1 combined with LncRNA XIST detection in the clinical diagnosis and prognosis assessment of bladder cancer was higher than that of single or paired detection (AUC=0.909, 95%CI:0.850～0.968;AUC=0.682, 95%CI:0.538～0.826). The 1-year survival rates of bladder cancer patients in VEGF, MCP-1, and LncRNA XIST high expression groups were significantly lower than those in low expression groups (P<0.05).Conclusions?? Detection of serum VEGF, MCP-1 combined with LncRNA XIST has high accuracy in the diagnosis of bladder cancer, which is of great value in assessing the prognosis.