知识与财富的链接
目的 探讨膀胱癌患者血清Dickkopf相关蛋白1(Dickkopf-related protein 1,DKK1)和DNA依赖性蛋白激酶催化亚基(protein kinase DNA-activated catalytic subunit,PRKDC)水平及其与患者预后的关系。方法 选取2020年3月~2022年3月于空军军医大学第二附属医院泌尿外科接受治疗的185例膀胱癌患者作为研究对象,随访3年,并根据随访期间预后情况分为预后不良组(n=35)与预后良好组(n=150)。收集两组患者的临床资料;采用酶联免疫吸附分析法检测血清DKK1、PRKDC水平;Spearman相关性分析明确膀胱癌发生预后不良患者DKK1、PRKDC水平的相关性;多因素Logistic回归分析膀胱癌患者预后的影响因素;受试者工作特征(receiver operating characteristic,ROC)曲线分析血清DKK1、PRKDC对膀胱癌患者预后的预测价值。结果 两组患者病理分级、病灶数目、淋巴结转移、TNM分期等资料比较,差异有统计学意义(P＜0.05);与预后良好组比较,预后不良组C反应蛋白(C-reactive protein,CRP)、中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、DKK1、PRKDC水平均升高(P＜0.05)。Spearman相关性分析显示,预后不良组患者血清DKK1水平与PRKDC水平呈显著正相关(r=0.6426,P＜0.001)。多因素Logistic回归分析结果显示,病理分级、病灶数目、淋巴结转移、TNM分期、CRP、NLR、DKK1水平升高、PRKDC水平升高均是膀胱癌患者预后的危险因素(P＜0.05)。ROC曲线分析结果显示,血清DKK1、PRKDC水平能够作为评估膀胱癌患者发生预后不良的有效指标。结论 血清DKK1、PRKDC水平升高与膀胱癌患者预后不良有关,且可作为潜在的生物学标志物用于膀胱癌的预后评估。
Objective To investigate the serum levels of Dickkopf-related protein 1 (DKK1) and protein kinase DNA-activated catalytic subunit (PRKDC) in patients with bladder cancer and their relationship with prognosis of patient. Methods A total of 185 patients with bladder cancer who were treated in the Department of Urology, the Second Affiliated Hospital of Air Force Medical University from March 2020 to March 2022 were selected as the research subjects and followed up for 3 years. They were divided into poor prognosis group (n = 35) and good prognosis group (n = 150) according to their prognostic outcomes during the follow-up period. The clinical data of patients in the two groups were collected, and the serum levels of DKK1 and PRKDC were detected by enzyme-linked immunosorbent assay. Spearman correlation analysis was used to clarify the correlation between the levels of DKK1 and PRKDC in patients with poor prognosis of bladder cancer. Multivariate Logistic regression analysis was used to analyze the influencing factors for the prognosis of patients with bladder cancer. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of serum DKK1 and PRKDC for prognosis in patients with bladder cancer. Results There were statistically significant differences in pathological grading, number of lesions, lymph node metastasis, TNM stage, and other data between the two groups (P<0.05). Compared with the good prognosis group, the levels of C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), DKK1, and PRKDC in the poor prognosis group were all increased (P<0.05). Spearman correlation analysis showed that there was a significant positive correlation between the serum levels of DKK1 and PRKDC in the poor prognosis group (r = 0.6426, P<0.001). The results of multivariate Logistic regression analysis showed that pathological grading, number of lesions, lymph node metastasis, TNM stage, elevated CRP, elevated NLR, elevated DKK1 level, and elevated PRKDC level were all risk factors affecting poor prognosis in patients with bladder cancer (P<0.05). ROC curve analysis showed that the serum levels of DKK1 and PRKDC could serve as effective indicators for assessing poor prognosis in patients with bladder cancer. Conclusion Elevated serum levels of DKK1 and PRKDC are associated with poor prognosis in patients with bladder cancer and can be used as potential biomarkers for prognosis assessment of bladder cancer.
