The effect of peripheral blood methylation hyaluronoglucosaminidase 2 level before initial chemotherapy in Ⅱ to Ⅲ rectal cancer patients undergoing adjuvant chemotherapy after surgery
10.3760/cma.j.cn115455-20240411-00325
- VernacularTitle:初次化疗前外周血甲基化透明质酸酶2水平对Ⅱ~Ⅲ期直肠癌术后辅助化疗患者预后的影响
- Author:
Zujin JI
1
;
Jun CHEN
Author Information
1. 锦州医科大学武汉大学研究生培养基地 湖北医药学院附属国药东风总医院结直肠肛门外科，十堰 442008
- Keywords:
Rectal neoplasms;
Hyaluronoglucosaminidase;
DNA methylation;
Biomarkers, tumor;
Prognosis
- From:
Chinese Journal of Postgraduates of Medicine
2024;47(9):840-845
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of peripheral blood methylation hyaluronoglucosaminidase 2 (HYAL2) before initial chemotherapy in Ⅱ to Ⅲ rectal cancer patients undergoing adjuvant chemotherapy after surgery.Methods:The clinical data of 98 patients with Ⅱ to Ⅲ rectal cancer from May 2019 to May 2021 in Sinopharm Dongfeng General Hospital, Hubei University of Medicine were retrospectively analyzed. All patients underwent adjuvant chemotherapy after radical surgery. The clinical characteristics of patients were record. The peripheral blood level of methylation HYAL2 before initial chemotherapy was detected by real-time fluorescence quantitative polymerase chain reaction. The cut-off value of peripheral blood methylation HYAL2 level was determined by X-tile 3.6.1 software. Multivariate Cox regression was used to analyze the independent risk factors of overall survival (OS) and disease-free survival (DFS) in patients with Ⅱ to Ⅲ rectal cancer. Kaplan-Meier survival curve was drawn to analyze the survival status in Ⅱ to Ⅲ rectal cancer patients with different peripheral blood level of methylation HYAL2. The efficacy of peripheral blood level of methylation HYAL2 in predicting the DFD and OS in patients with Ⅱ to Ⅲ rectal cancer was evaluated by the receiver operating characteristics (ROC) curve.Results:The peripheral blood level of methylation HYAL2 in 98 patients with Ⅱ to Ⅲ rectal cancer before initial chemotherapy was (45.13 ± 12.13)%, and the cut-off for evaluating OS was 43.18% by X-tile 3.6.1 software. Among them, 66 cases were high expression (peripheral blood level of methylation HYAL2 ≥43.18%), and 32 cases were low expression (<43.18%). The tumor diameter and TNM stage were the affect factors of peripheral blood level of methylation HYAL2 in patients with Ⅱ to Ⅲ rectal cancer ( P<0.05); the peripheral blood level of methylation HYAL2 was not related to gender, age, differentiation degree, lymph node metastasis and depth of invasion ( P>0.05). Multivariate Cox regression analysis result showed that TNM stage and peripheral blood level of methylation HYAL2 were the independent risk factors of OS in patients with Ⅱ to Ⅲ rectal cancer ( HR = 0.451 and 1.697, 95% CI 0.204 to 1.001 and 0.309 to 2.787, P<0.05); the peripheral blood level of methylation HYAL2 was an independent risk factor of DFS in patients with Ⅱ to Ⅲ rectal cancer ( HR = 1.027, 95% CI 0.146 to 1.943, P<0.05). Kaplan-Meier survival curve analysis result showed that the median OS and DFS in patients with low peripheral blood level of methylation HYAL2 were significantly longer than those in patients with high peripheral blood level of methylation HYAL2 (29 months vs. 21 months and 26 months vs. 21 months), and there were statistical differences (log-rank χ2 = 12.57 and 8.66, P<0.05). ROC curve analysis result showed that the area under curve (AUC) of peripheral blood level of methylation HYAL2 to predict the OS in patients with Ⅱ to Ⅲ rectal cancer was 0.882 (95% CI 0.801 to 0.938), with the specificity of 65.67% and the sensitivity of 99.45%; the AUC of peripheral blood level of methylation HYAL2 to predict the DFS in patients with Ⅱ to Ⅲ rectal cancer was 0.847 (95% CI 0.760 to 0.913), with the specificity of 62.90% and the sensitivity of 97.22%. Conclusions:The peripheral blood level of methylation HYAL2 before initial chemotherapy is an independent risk factor of prognosis in Ⅱ to Ⅲ rectal cancer patients undergoing adjuvant chemotherapy after surgery, and it can serve as an index for prognostic evaluation.
