Purpose: To investigate the correlations of recurrence after radical surgery for esophageal cancer with glucose-lipid metabolism, insulin resistance, inflammation, stress and serum p53 expression.
Methods: A total of 80 patients with esophageal cancer treated in our hospital from February 2015 to October 2017 were selected and divided into two groups with 40 cases in each group. All patients enrolled underwent open radical surgery for esophageal cancer, combined with chemoradiotherapy and biotherapy after surgery, and all of them were followed up for 1 year. Postoperative recurrence, glucose-lipid metabolism, insulin resistance and inflammatory and stress responses were compared. Additionally, the serum p53 antibody index was recorded. Moreover, the relevant and independent risk factors and the correlations of postoperative recurrence time of esophageal cancer were analyzed.
Results: At 1-year follow-up after surgery, the levels of glucose-lipid metabolism indices, inflammatory factors and stress response in recurrence group were significantly higher than those in non-recurrence group (p<0.05), while the insulin resistance, the superoxide dismutase level and total antioxidant capacity in recurrence group were significantly greater than that in non-recurrence group (p<0.05). Besides, at 6-month and 1-year follow-up, the serum P53 antibody index in recurrence group was obviously higher than that in non-recurrence group (p<0.05). The complicated hypertension, hyperlipidemia and diabetes mellitus were relevant and independent risk factors for the postoperative recurrence of esophageal cancer (p<0.05). The postoperative recurrence time of esophageal cancer was negatively correlated with the levels of fasting blood glucose, total cholesterol, insulin resistance, high-sensitivity C-reactive protein and serum P53 antibody index (p<0.05), while it was positively correlated with the superoxide dismutase level (p<0.05).
Conclusions: The complicated hypertension, hyperlipidemia and diabetes mellitus are relevant and independent risk factors for the postoperative recurrence of esophageal cancer. The earlier postoperative recurrence time corresponds to the higher levels of fasting blood glucose, insulin resistance index and total cholesterol, and the stronger inflammatory and oxidative stress responses. At the same time, the changes in the p53 level have a certain guidance value in predicting the postoperative recurrence.