|
|
|
| Relationship between Serum GDF-15 and FGF23 Expression with Nutritional Status and Prognosis in Elderly Esophageal Cancer Patients |
| XUE Qian, TIAN Ruiyuan |
| No.215 Hospital of Nuclear Industry of Shaanxi, Shaanxi Xianyang 712000, China |
|
|
|
|
Abstract Objective: To explore the relationship between the expression of serum growth differentiation factor-15 (GDF-15) and fibroblast growth factor 23 (FGF23) in elderly patients with esophageal cancer and their nutritional status and prognosis. Methods: A total of 117 elderly patients with esophageal cancer (case group) and 117 elderly healthy individuals (control group) admitted to our hospital from February 2019 to February 2021 were selected as the research subjects. The expression levels of GDF-15 and FGF23 in the serum of elderly patients with esophageal cancer were detected by ELISA, and the relationship between the two and clinical pathological characteristics was analyzed; the correlation between the levels of GDF-15 and FGF23 and nutritional status indicators [Nutritional Risk Screening 2002 (NRS-2002) score, Patient-Generated Subjective Global Assessment (PG-SGA)] were analyzed by Spearman method; Logistic regression was used to analyze the influencing factors of death in elderly patients with esophageal cancer; the value of GDF-15 and FGF23 in predicting the prognosis of elderly patients with esophageal cancer was analyzed by ROC curve. Results: Compared with the control group, the levels of GDF-15 and FGF23 and the NRS-2002 and PG-SGA scores in the case group were increased (P<0.05). The expression levels of GDF-15 and FGF23 were related to lymph node metastasis and TNM stage (P<0.05). The results of Spearman correlation analysis showed that GDF-15 was positively correlated with NRS-2002 and PG-SGA scores (P<0.05), and FGF23 was positively correlated with NRS-2002 and PG-SGA scores (P<0.05). The expression levels of GDF-15 and FGF23 and the NRS-2002 and PG-SGA scores in the death group were higher than those in the survival group (P<0.05). Multivariate Logistic regression analysis showed that lymph node metastasis, GDF-15, and FGF23 were risk factors affecting the prognosis of death in elderly patients with esophageal cancer (P<0.05). The ROC curve analysis showed that the AUCs of GDF-15 and FGF23 levels in predicting the prognosis of death in patients were 0.878 and 0.767, respectively, and the AUC of the combined prediction of the two was 0.920, which was greater than the AUCs of the two predictions alone (P<0.05). Conclusion: The expression levels of GDF-15 and FGF23 in the serum of elderly patients with esophageal cancer are elevated, and their expression levels are related to lymph node metastasis, TNM stage, and nutritional status. The combination of the two can be used as an effective serological detection tool to predict the prognosis of patients.
|
|
|
|
|
|
[1] Tay SW,Li JW,Fock KM.Diet and cancer of the esophagus and stomach[J].Curr Opin Gastroenterol,2021,37(2):158-163.
[2] 高云鸽,程天一,钱罗蒙,等.GDF-15在肿瘤发生发展及免疫调节中作用的研究进展[J].中国免疫学杂志,2020,36(14):1784-1787.
[3] Yokoyama A,Hasegawa T,Hiraga T,et al.Altered immunolocalization of FGF23 in murine femora metastasized with human breast carcinoma MDA-MB-231 cells[J].Bone Miner Metab,2021,39(5):810-823.
[4] 车俊,张福正,邹勤舟,等.选择性淋巴引流区照射与累及野照射联合化疗治疗食管癌效果分析[J].肿瘤研究与临床,2022,34(4):271-275.
[5] Koga C,Yamashita K,Yukawa Y,et al.The impact of postoperative blood glucose levels on complications and prognosis after esophagectomy in patients with esophageal cancer[J].Surg Today,2023,53(8):907-916.
[6] 骆毅超,王真权.结直肠癌患者血清GDF-15、IGF-1、胸苷激酶1、癌胚抗原水平变化及意义[J].中国卫生工程学,2024,23(3):400-403.
[7] 蒋富强,解鹏,张嘉诚,等.血清FGF19、GDF15对肝癌介入治疗患者预后的评估价值[J].标记免疫分析与临床,2024,31(2):203-207,345.
[8] Deng J,Zhang M,Zhang H,et al.Value of growth/differentiation factor 15 in diagnosis and the evaluation of chemotherapeutic response in lung cancer[J].Clin Ther,2021,43(4):747-759.
[9] Yang L,Cai Y,Wang Y,et al.Fibroblast growth factor 23 is a potential prognostic biomarker in uterine sarcoma[J].Technol Cancer Res Treat,2024,23(1):1-10.
[10] Fang L,Li Z,Yu B,et al.FGF23 promotes proliferation,migration and invasion by regulating miR-340-5p in osteosarcoma[J].Orthop Surg Res,2023,18(1):12-24.
[11] Hao J,Chen C,Wan F,et al.Prognostic value of pre-treatment prognostic nutritional index in esophageal cancer:a systematic review and meta-analysis[J].Front Oncol,2020,10(3):797-806. |
|
|
|
2025, Vol. 31 
