术前血清GDF-8、TTF-1水平与腹腔镜结直肠癌根治术后复发转移的关系OA

Objective To investigate the association of preoperative serum levels of growth differentiation factor-8(GDF-8)and thyroid transcription factor-1(TTF-1)with postoperative recurrence and metastasis in patients undergoing laparoscopic radical resection for colorectal cancer.Methods A total of 128 patients with colorectal cancer who underwent laparoscopic radical resection at our hospital between October 2022 and October 2024 were enrolled.Patients were categorized into recurrence/metastasis(n=34)and non-recurrence/metastasis(n=94)groups based on postoperative events within 12 months.Serum GDF-8 and TTF-1 levels were compared between groups.Predictive value was assessed via receiver operating characteristic(ROC)curve analysis.Univariable analysis was performed,followed by multivariable stepwise logistic regression analysis to identify factors influencing postoperative recurrence and metastasis in patients undergoing laparoscopic colorectal cancer resection.Results Preoperative and postoperative GDF-8 and TTF-1 levels were significantly higher in the recurrence/metastasis group than in the non-recurrence/metastasis group(P＜0.05).Postoperative GDF-8 levels increased in both groups(P＜0.05),while postoperative TTF-1 levels decreased in both groups(P＜0.05).ROC curve analysis revealed that the AUC of preoperative GDF-8 combined with preoperative TTF-1 in predicting postoperative recurrence and metastasis in colorectal cancer patients undergoing laparoscopic radical resection was 0.904(95％CI:0.873,0.942),higher than that of either individual marker.The combined prediction demonstrated a sensitivity of 85.3％(95％CI:0.832,0.873)and a specificity of 86.2％(95％CI:0.842,0.881).The proportions of patients aged ≥ 60 years and those with TNM stage Ⅲ disease,poorly differentiated tumors,lymphovascular invasion,perineural invasion,and tumor diameter ≥ 5 cm were all higher in the recurrence/metastasis group than in the non-recurrence/metastasis group(P＜0.05).Multivariable stepwise logistic regression analysis revealed that TNM stage Ⅲ disease[(O^R)=3.435(95％CI:1.562,7.553)],poorly-differentiated tumors[(O^R)=3.016(95％CI:1.592,5.714)],tumor diameter ≥5 cm[(O^R)=2.678(95％CI:1.436,4.994)],preoperative GDF-8 ≥ 16.83 μg/L[(O^R)=2.782(95％CI:1.509,5.127)],and preoperative TTF-1 ≥ 15.47 μg/L[OR=2.759(95％CI:1.428,5.331)]were all risk factors for postoperative recurrence and metastasis in colorectal cancer patients undergoing laparoscopic radical resection(P＜0.05).Conclusion Elevated preoperative serum GDF-8 and TTF-1 levels are closely associated with postoperative recurrence and metastasis in colorectal cancer patients undergoing laparoscopic radical resection,and combined detection of both markers demonstrates good predictive efficacy.