血清KLF5含量与阳性淋巴结比例的相关性及其对膀胱癌患者根治术后预后的预测价值

Correlation between serum KLF5 content and positive lymph node ratio and its predictive value for prognosis of patients with bladder cancer after radical operation

摘要:

目的 探究血清Kruppel样因子5（recombinant Kruppel factor 5，KLF5）含量与阳性淋巴结比例的相关性及其对膀胱癌患者根治术后预后的预测价值。方法 选取新乡市中心医院和郑州大学第一附属医院泌尿外科2019年6月至2022年9月进行根治性膀胱切除术治疗的92例膀胱癌患者作为研究对象，根据疗效分为有效组和无效组。酶联免疫吸附法检测血清KLF5的表达水平、分析血清KLF5含量与阳性淋巴结比例的相关性和预后的预测价值分析。结果 治疗有效组患者血清KLF5的表达水平显著低于无效组（P<0.05）；有效组患者阳性淋巴结比例与无效组相比，具有显著差异（P<0.05）；采用Pearson分析血清KLF5与阳性淋巴结比例间关系，发现血清KLF5与阳性淋巴结比例呈正相关（r=0.607）；logistic多因素回归分析显示，血清KLF5（OR=2.751，95%CI=1.777~4.260，P=0.000）与阳性淋巴结比例（OR=2.751，95%CI=1.389~7.342，P=0.006）是影响膀胱癌根治术患者病情预后的独立危险因素；ROC结果显示，血清KLF5与阳性淋巴结比例对预测膀胱癌根治术患者预后的曲线下面积（area under the curve，AUC）分别为0.909、0.748，对应灵敏度分别为80.71%、93.26%，特异度分别为91.24%、92.50%。二者联合诊断的AUC为0.929，灵敏度和特异度分别为92.30%和92.50%。结论 血清KLF5和阳性淋巴结比例是膀胱根治术患者预后的独立危险因素，并且KLF5与患者的阳性淋巴结比例呈正相关，因此在预测膀胱根治术患者预后的过程中，动态检测相关影响因素的变化可以为临床医生诊断病情提供依据。

Abstract:

Objective To explore the correlation between serum recombinant Kruppel factor 5（KLF5） content and positive lymph node ratio and its predictive value for the prognosis of patients with bladder cancer after radical operation.Methods Ninety-two patients in Department of Urinary Surgery，Xinxiang Central Hospital and The First Affiliated Hospital of Zhengzhou University with bladder cancer treated by radical cystectomy from June 2019 to September 2022 were selected for the study，and they were divided into effective and ineffective groups according to their efficacy. The expression level of serum KLF5 was obtained by enzyme-linked immunosorbent assay. The correlation between serum KLF5 content and positive lymph node ratio and its predictive value for prognosis were analyzed.Results The expression level of serum KLF5 in patients in the effective group was significantly lower than that in the ineffective group（P<0.05）； the positive lymph node ratio in patients in the effective group was significantly different compared with that in the ineffective group（P<0.05）. Pearson analysis showed that a positive correlation was found between serum KLF5 and positive lymph node ratio（odds ratio=0.607；P=0.000）. Multivariate logistic regression analysis showed that serum KLF5（OR=2.751，95%CI=1.777-4.260，P=0.000） and positive lymph node ratio（OR=2.751，95%CI=1.389-7.342，P=0.006） were independent risk factors affecting the prognosis of patients undergoing radical cystectomy（P<0.05）. The receiver operating characteristic curve results showed that the areas under the curve（AUCs） of serum KLF5 and positive lymph node ratio were 0.909 and 0.748，respectively，for predicting the prognosis of patients undergoing radical cystectomy. The corresponding sensitivity was 80.71% and 93.26%，and the specificity was 91.24% and 92.50%，respectively. The AUC for the combined diagnosis of the two indicators was 0.929，with a sensitivity and specificity of 92.30% and 92.50%，respectively.Conclusion Serum KLF5 and positive lymph node ratio are independent risk factors for the prognosis of patients undergoing radical cystectomy，and KLF5 is positively correlated with positive lymph node ratio in patients undergoing radical cystectomy. Therefore，in the process of predicting the prognosis of patients undergoing radical cystectomy，dynamic detection of changes in related influencing factors can provide a basis for clinicians to diagnose the disease.