| Objectives:Gallbladder cancer is a relatively common malignant tumor of the digestive system.Early symptoms are concealed and the degree of malignancy is high.Surgical resection is the only treatment that may cure gallbladder cancer.Early gallbladder cancer still has surgery opportunities and the prognosis is comparatively well.However,most of the patients who with advanced gallbladder cancer always have metastasized when they are treated,and usually have poor prognosis,or even lose the opportunity of surgery.Growth differentiation factor 15(GDF-15)is a kind of growth factor,which belongs to the members of the TGF-P(transforming growth factor ?)super-family.This study preliminarily analyzed the expression of GDF-15 in gallbladder cancer and its significance,and explored the relationship between GDF-15 expression and clinicopathological characteristics and prognosis of patients with gallbladder cancer.Methods:1.The expression of GDF-15 in serum of 42 patients with gallbladder cancer was measured by enzyme linked immunosorbent assay(ELISA),and 24 patients with cholecystitis and 20 healthy volunteers were used as controls.2.Immunohistochemistry was used to detect the expression of GDF-15 in 42 cases of gallbladder cancer and 35 cases of non-tumor gallbladder tissue that adjacent to the cancer,and obtain the expression of GDF-15 in each group.Results:1.The results of ELISA showed that the concentration of GDF-15 in serum was higher in gallbladder cancer than that in benign lesions of gallbladder and healthy volunteers(P=0.006,P<0.001).2.The results of immunohistochemistry showed that the expression of GDF-15 in tumor tissue was significantly higher than that in non tumor gallbladder tissue(P=0.003),and the high expression of GDF-15 was significantly correlated with differentiation degree of gallbladder carcinoma and TNM stage of tumor(P=0.005,P=0.002),3.The results of ROC curve suggested that GDF-15 in serum can be used as a tumor marker to predict gallbladder cancer(sensitivity 83.3%,specificity 72.7%,P<0.001),and can also be used to predict lymph node metastasis of gallbladder cancer(sensitivity 90.9%,specificity 80%,P<0.001).4.The results of Kaplan-Meier method showed that the expression of GDF-15 was related to the prognosis of the patients.and the average survival time of the strong positive group was lower than that of the middle positive group and the weak positive group(6.65 months vs 8.2 months,P=0.045;6.65 months vs 17.7 months,P=0.003).5.Single factor analysis of COX risk regression model suggested that TNM stage(P=0.008),tumor differentiation degree(P=0.028)and the expression of GDF-15(P=0.003)were related to the prognosis of patients with gallbladder cancer.Further multivariate analysis showed that the expression of GDF-15 and TNM stage were independent risk factors which related to the prognosis of gallbladder cancer(P=0.009,P=0.035).Conclusions:1.GDF-15 is related to the occurrence and development of gallbladder cancer.GDF-15 in Serum can be used as a potential marker for the diagnosis of gallbladder cancer,and it can also be used to predict lymph node metastasis of gallbladder cancer.2.The high expression of GDF-15 in tissues is an independent risk factor related to the poor prognosis of gallbladder cancer,which can be used as a marker to predict the prognosis of gallbladder cancer.The measurement of GDF-15 in tissue can help to determine the stage of gallbladder cancer,the degree of tumor differentiation and provide help to postoperative comprehensive treatment of gallbladder cancer. |
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