结直肠癌患者血清GDF-15、G-CSF水平与临床病理特征及预后的关系

摘要 目的：探究结直肠癌血清生长分化因子-15（GDF-15）、粒细胞集落刺激因子（G-CSF）水平与患者临床病理参数、预后的关系，并分析其对结直肠癌的诊断价值。方法：采集结直肠癌患者、结直肠腺瘤患者及健康体检志愿者的血清样本，酶联免疫吸附测定（ELISA）实验检测血清GDF-15、G-CSF；分析结直肠癌患者血清GDF-15、G-CSF水平与患者临床病理参数的关系；Kaplan Meier生存曲线分析血清GDF-15、G-CSF水平与患者预后的关系；受试者工作特征曲线（ROC）分析血清GDF-15、G-CSF水平对结直肠癌的诊断价值。结果：结直肠癌患者血清GDF-15、G-CSF水平高于结直肠腺瘤患者及健康体检志愿者（均P<0.05）；血清GDF-15水平与肿瘤直径、分化程度、远处转移及TNM分期相关（均P<0.05）；血清G-CSF水平与肿瘤分化程度、远处转移及TNM分期相关（均P<0.05）；Kaplan Meier生存曲线结果显示，血清GDF-15低表达、G-CSF低表达患者的术后5年总生存率及中位生存时间均分别高于血清GDF-15高表达、G-CSF高表达患者（均P<0.05）；ROC分析结果表明，血清GDF-15、G-CSF有较好的诊断结直肠癌的价值，血清GDF-15、G-CSF联合应用的敏感度、特异度分别为0.876、0.863。结论：结直肠癌患者血清GDF-15、G-CSF水平升高，且均与患者病情恶性进展、不良预后相关；血清GDF-15、G-CSF是诊断结直肠癌的潜在指标。

Correlation of Serum GDF-15, G-CSF Levels with the Clinicopathological Characteristics and Prognosis in Patients with Colorectal Cancer

ABSTRACT Objective: To investigate the correlation of serum growth differentiation factor-15 (GDF-15), granulocyte colony stimulating factor (G-CSF) levels with the clinicopathological characteristics and prognosis in patients with colorectal cancer, and to analyze their diagnostic value for colorectal cancer. Methods: Serum samples were collected from patients with colorectal cancer, patients with colorectal adenoma and healthy volunteers. The serum levels of GDF-15, G-CSF were detected by the enzyme linked immunosorbent assay (ELISA). The correlation between the serum GDF-15, G-CSF with the clinicopathological characteristics were analyzed. Kaplan Meier survival curve was used to analyse of the relationship between serum GDF-15, G-CSF levels and prognosis of patients. The diagnostic value of serum GDF-15 and G-CSF levels in colorectal cancer was analyzed by receiver operating characteristic curve (ROC). Results: The serum levels of GDF-15 and G-CSF in patients with colorectal cancer were higher than those in patients with colorectal adenoma and healthy volunteers (all P<0.05). Serum GDF-15 level were related with tumor diameter, differentiation degree, distant metastasis and the TNM stage (all P<0.05). Serum G-CSF level were related with differentiation degree, distant metastasis and the TNM stage (all P<0.05). Kaplan Meier results showed that the 5-year overall survival rate, the medium survival time in the low GDF-15 group and the low G-CSF group were higher than those in the high GDF-15 group and the high G-CSF group (all P<0.05). Moreover, ROC analysis showed that serum GDF-15, G-CSF had a good value in the diagnosis of colorectal cancer, the sensitivity and specificity of combined detection of serum GDF-15, G-CSF were 0.876 and 0.863 respectively. Conclusion: The serum GDF-15, G-CSF in the colorectal cancer patients are up-regulated, which are both related with malignant progression and poor prognosis. The serum GDF-15, G-CSF are potential indicators for the diagnosis of colorectal cancer.