血清脂联素和脂蛋白相关磷脂酶2水平与晚期前列腺癌化疗效果及临床预后的相关性
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摘要
目的探讨血清脂联素(APN)和脂蛋白相关蛋白磷脂酶2(PLA-2)水平与晚期前列腺癌化疗效果及临床预后的关系。方法收集该院2012年9月至2013年9月收治的80例晚期前列腺癌患者,均行化学治疗,并采用酶联免疫吸附法检测患者血清APN、PLA-2水平,探讨APN、PLA-2水平与前列腺癌化疗效果和化疗不良反应的关系,采用Logistic回归分析前列腺癌患者预后的风险因素。结果 APN低水平组患者完全缓解(CR)、部分缓解(PR)、稳定(SD)、疾病进展(PD)、客观有效(RR)分别有9、8、7、13例,化疗有效率明显低于高水平组患者(P<0.05);而PLA-2低水平组患者CR、PR、SD、PD、RR分别有11、12、9、8例,化疗有效率明显高于高水平组(P<0.05)。APN低水平组患者恶心呕吐、白细胞减少、肝功能异常、外周神经毒性分别为25、18、19、9例,各并发症发生率明显高于高水平组(P<0.05),而PLA-2低水平组各并发症发生分别有11、14、13、5例,明显低于高水平组(P<0.05)。肿瘤TNM分期(P=0.02)、APN(P=0.03)、PLA-2(P=0.01)是前列腺癌患者病死、转移或复发的独立危险因素。结论血清APN和PLA-2水平与前列腺癌化疗效果及临床预后密切相关,是患者预后不良的独立危险因素。
Objective To investigate the relationship between the level of serum adiponectin and lipoprotein related protein phospholipase 2 in patients with advanced prostate cancer.Methods In the hospital from September 2012 to September 2013,80 cases of advanced prostate cancer patients were as the objects of study,all patients underwent chemotherapy,and were detected by enzyme-linked immunosorbent assay in serum adiponectin and lipoprotein associated phospholipase 2 levels of adiponectin in serum(Adiponectin/APN),lipoprotein associated phospholipase Lipoprotein-associated(phospholipase A-2 Level 2 the relationship between the level of PLA-2),and the effect of chemotherapy in prostate cancer and the adverse reaction of chemotherapy,using logistics regression analysis of risk factors of prognosis of patients with prostate cancer.ResultsLow levels of APN in patients with CR,PR,SD,PD,RR were 9,8,7,13 cases of chemotherapy,effective rate was significantly lower than the high level group(P<0.05),and low levels of PLA-2,PR,SD,CR in patients with PD and RR respectively in 11,12,9,8 cases,the effective rate of chemotherapy was significantly higher than that of the control group(P<0.05).The low level of APN in patients with malignant vomiting,leukopenia,abnormal liver function and peripheral neurotoxicity were 25,18,19,9 cases,the complication rate was significantly higher than that of the high level group of APN(P<0.05),and the incidence of PLA-2 of the complications were 11 cases,14 cases,13 cases,5 cases were significantly lower than that of the high level group(P<0.05).PLA-2 tumor TNM stage(P=0.02),APN(P=0.03),PLA-2(P=0.01)were independent risk factors of death in patients with prostate cancer,metastasis or recurrence.Conclusion The levels of APN and PLA-2 in serum are closely related to the clinical efficacy and prognosis of prostate cancer,and are the independent risk factors for poor prognosis.
Objective To investigate the relationship between the level of serum adiponectin and lipoprotein related protein phospholipase 2 in patients with advanced prostate cancer.Methods In the hospital from September 2012 to September 2013,80 cases of advanced prostate cancer patients were as the objects of study,all patients underwent chemotherapy,and were detected by enzyme-linked immunosorbent assay in serum adiponectin and lipoprotein associated phospholipase 2 levels of adiponectin in serum(Adiponectin/APN),lipoprotein associated phospholipase Lipoprotein-associated(phospholipase A-2 Level 2 the relationship between the level of PLA-2),and the effect of chemotherapy in prostate cancer and the adverse reaction of chemotherapy,using logistics regression analysis of risk factors of prognosis of patients with prostate cancer.ResultsLow levels of APN in patients with CR,PR,SD,PD,RR were 9,8,7,13 cases of chemotherapy,effective rate was significantly lower than the high level group(P<0.05),and low levels of PLA-2,PR,SD,CR in patients with PD and RR respectively in 11,12,9,8 cases,the effective rate of chemotherapy was significantly higher than that of the control group(P<0.05).The low level of APN in patients with malignant vomiting,leukopenia,abnormal liver function and peripheral neurotoxicity were 25,18,19,9 cases,the complication rate was significantly higher than that of the high level group of APN(P<0.05),and the incidence of PLA-2 of the complications were 11 cases,14 cases,13 cases,5 cases were significantly lower than that of the high level group(P<0.05).PLA-2 tumor TNM stage(P=0.02),APN(P=0.03),PLA-2(P=0.01)were independent risk factors of death in patients with prostate cancer,metastasis or recurrence.Conclusion The levels of APN and PLA-2 in serum are closely related to the clinical efficacy and prognosis of prostate cancer,and are the independent risk factors for poor prognosis.
引文
[1]杨金辉,代光成,许立军,等.转移性前列腺癌化疗联合内分泌治疗1例[J].中国肿瘤临床,2015,10(9):491.
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[9]冯建勇,陶晶,沈志远,等.培美曲塞联合奥沙利铂二线化疗治疗转移性去势抵抗性前列腺癌初步观察[J].中国男科学杂志,2016,30(7):8-10.
[10]张姣,翁少波,王海涛,等.改良Glasgow预后评分对去势抵抗性前列腺癌患者多西他赛化疗后总生存期的影响及临床分析[J].中华泌尿外科杂志,2015,36(4):294-298.
[11]孙超群,庞自力,潘峰,等.脂联素在前列腺癌组织中的表达及意义[J].临床泌尿外科杂志,2010,25(10):780-783.
[12]周萍,富路,王秋军,等.老年前列腺癌去势治疗对血清脂联素及颈动脉内膜-中层厚度的影响[J].实用老年医学,2011,25(5):384-387.
[13]戴丽萍.ACI患者血清APN和hs-CRP测定的临床意义[J].放射免疫学杂志,2012,25(6):685-686.
[14]张学慧,张鹏.磷脂酶A2与肿瘤发生相关性研究进展[J].中国肿瘤临床,2014,23(15):1007-1010.
[15]万青,邓华聪,邱鸿鑫,等.2型糖尿病患者血浆TXA2和PGI2失衡及PLA2活性变化[J].重庆医科大学学报,2001,26(3):257-260.
[2]拜艳华,陶英波,张国栋,等.动脉内化疗栓塞治疗晚期前列腺肉瘤的初步研究[J].医学影像学杂志,2016,26(8):1471-1473.
[3]顾成元,李巧新,朱耀,等.脂联素基因多态性与前列腺癌发病风险的相关性研究[J].中华泌尿外科杂志,2014,35(5):395-396.
[4]苏佳,刘泽源,赵振虎,等.PLA2/AA信号途径与皂苷诱导大鼠子宫平滑肌收缩活动的关系研究[J].军事医学科学院院刊,2008,32(3):264-268.
[5]马志方,郝斌,曾胜,等.联合检测晚期前列腺癌表皮生长因子受体基因突变和常用化疗药物敏感性相关基因多态性及其临床意义[J].中国药物与临床,2016,16(11):1569-1572.
[6]胡娜,孟凡旭,于鹏跃,等.前列腺酸性磷酸酶负载的树突细胞联合细胞因子诱导杀伤细胞过继免疫治疗晚期激素难治性前列腺癌的临床研究[J].中国老年学杂志,2016,36(8):1893-1895.
[7]王雯,熊伟,李晓颖,等.2′-羟基黄烷酮对前列腺癌细胞的放射增敏作用及机制探讨[J].中华放射肿瘤学杂志,2016,25(5):513-518.
[8]朱清毅,张庆玲,张鑫,等.前列腺小细胞癌的临床观察[J].江苏医药,2014,40(23):2923-2924.
[9]冯建勇,陶晶,沈志远,等.培美曲塞联合奥沙利铂二线化疗治疗转移性去势抵抗性前列腺癌初步观察[J].中国男科学杂志,2016,30(7):8-10.
[10]张姣,翁少波,王海涛,等.改良Glasgow预后评分对去势抵抗性前列腺癌患者多西他赛化疗后总生存期的影响及临床分析[J].中华泌尿外科杂志,2015,36(4):294-298.
[11]孙超群,庞自力,潘峰,等.脂联素在前列腺癌组织中的表达及意义[J].临床泌尿外科杂志,2010,25(10):780-783.
[12]周萍,富路,王秋军,等.老年前列腺癌去势治疗对血清脂联素及颈动脉内膜-中层厚度的影响[J].实用老年医学,2011,25(5):384-387.
[13]戴丽萍.ACI患者血清APN和hs-CRP测定的临床意义[J].放射免疫学杂志,2012,25(6):685-686.
[14]张学慧,张鹏.磷脂酶A2与肿瘤发生相关性研究进展[J].中国肿瘤临床,2014,23(15):1007-1010.
[15]万青,邓华聪,邱鸿鑫,等.2型糖尿病患者血浆TXA2和PGI2失衡及PLA2活性变化[J].重庆医科大学学报,2001,26(3):257-260.