Expression of GDF-15 in different pathological types of prostate cancer and its association with postoperative biochemical recurrence
10.3760/cma.j.cn115396-20240822-00259
- VernacularTitle:GDF-15在不同病理类型前列腺癌中的表达及与术后生化复发的关系
- Author:
Kang LI
1
;
Dan YUAN
;
Mingsong WANG
;
Xiao ZHONG
;
Yu WANG
Author Information
1. 三六三医院泌尿外科，成都 610041
- Keywords:
Prostatic neoplasms;
Carcinoma;
Growth differentiation factor-15;
Pathological type;
Recurrence
- From:
International Journal of Surgery
2025;52(10):671-678
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the expression of growth differentiation factor-15 (GDF-15) in different pathological types of prostate cancer, and to analyze the impact of GDF-15 on biochemical recurrence of prostate cancer after radical prostatectomy.Methods:A retrospective analysis was conducted on the case data of 138 patients with prostate cancer who underwent radical prostatectomy at the 363rd Hospital from January 2019 to January 2022. The patients were divided into the recurrence group ( n=46) and the non-recurrence group ( n=92) based on postoperative biochemical recurrence. Measurement data were expressed as mean±standard deviation ( ± s), and analysis of variance was used for comparisons among multiple groups, while t-test was used for comparisons between two groups. Count data were expressed as the number of cases and percentages, and the Chi-test was used for comparisons between groups. Stratified regression analysis was used to explore the relationship between GDF-15 and different clinical pathological characteristics. By combining spline functions and Logistic regression analysis, the restricted cubic spline model was used to analyze the effect of GDF-15 on biochemical recurrence of prostate cancer in different pathological types. Kaplan-Meier survival curves were drawn to visually display the recurrence differences of prostate cancer patients at different GDF-15 levels. Results:The expression level of GDF-15 was the lowest in Gleason grade group (GGG)1 type at (548.71±78.25) pg/mL, and the highest in GGG5 type at (916.75±94.33) pg/mL, and the difference was statistically significant ( F=87.39, P<0.001). The level of GDF-15 was positively correlated with prostate-specific antigen (PSA), GGG5 type, and vascular endothelial growth factor (VEGF) ( P=0.029, 0.022, 0.015). The levels of PSA, GDF-15, Gleason score, alkaline phosphatase (ALP), C-reactive protein (CRP)/albumin (ALB), VEGF, and the proportion of TNM stage Ⅲ-Ⅳ, lymph node invasion, seminal vesicle invasion, nerve invasion, capsule rupture, and GGG5 type in the recurrence group were significantly higher than those in the non-recurrence group, the differences were all statistically significant ( P<0.05); the lymphocyte-to-monocyte ratio (LMR) was significantly lower than that in the non-recurrence group, and the difference was statistically significant ( P<0.001). GDF-15 had a non-linear dose-response relationship with the biochemical recurrence risk value. The risk value is significantly positively correlated with the level of GDF-15, and this relationship was not affected by the type of prostate cancer pathology. In patients with GGG1 to GGG5 types of prostate cancer, when the GDF-15 levels were >720, 700, 690, 650, and 610 pg/mL, respectively, the risk values increased as the GDF-15 levels rose. The Kaplan-Meier survival curve analysis showed that as the level of GDF-15 increased, the recurrence rate of patients significantly rose. Conclusions:The expression level of GDF-15 expression is the lowest in GGG1 type and the highest in GGG5 type. Both GDF-15 and GGG5 type are the independent risk factors for biochemical recurrence after radical prostatectomy, and GDF-15 exhibits a significant positive nonlinear dose-response relationship with the risk of biochemical recurrence.
