内科

目的探讨胸水中可溶性生长刺激表达基因2蛋白（sST2）、肌动蛋白交联蛋白（Fascin）含量和癌细胞恶性增殖、侵袭基因表达水平以及它们之间相关性，为判定胸水性质、明确诊断、指导治疗提供参考。方法回顾分析2017年1月至2019年2月在我院治疗的肺癌合并恶性胸水患者50例（研究组）和低蛋白血症合并胸水患者或心力衰竭合并胸水患者30例（对照组）的临床资料，比较两组患者胸水中的sST2、Fascin含量以及癌细胞恶性增殖、侵袭基因的表达水平；对肺癌患者胸水sST2、Fascin含量与其癌细胞恶性增殖、侵袭基因的表达水平进行Pearson相关性分析。结果研究组患者的sST2、Fascin含量显著高于对照组，差异有统计学意义（P＜0.05）。研究组患者胸水癌细胞的恶性增殖基因BCL2、KI-67的表达水平显著高于对照组，LKB1、MTS1的表达水平显著低于对照组，差异有统计学意义（P＜0.05）。研究组患者胸水癌细胞恶性侵袭基因MMP9、N-cadherin的表达水平显著高于对照组，E-cadherin、TMSG-1及Bin-1的表达水平显著低于对照组，差异有统计学意义（P＜0.05）。Pearson相关性分析结果显示，研究组患者胸水中的sST2、Fascin含量与其癌细胞中恶性增殖基因LKB1、MTS1及恶性侵袭基因E-cadherin、TMSG-1及Bin-1的表达水平呈负相关，与恶性增殖基因BCL2、KI-67及恶性侵袭基因MMP9、N-cadherin的表达水平呈正相关。结论患者胸水中的sST2、Fascin含量、恶性增殖基因BCL2、KI-67及恶性侵袭基因MMP9、N-cadherin的表达水平与患者胸水的性质密切相关，这对明确胸水性质并对患者进行正确诊断和治疗具有重要的参考价值。

ObjectiveTo explore the contents of soluble suppression of tumorigenicity 2 (sST2), actin cross-linking protein (Fascin) and the expression levels of cancer cell malignant proliferation and invasion genes in the hydrothorax and their correlations, to determine the properties of the hydrothorax, to make a clear diagnosis, and to provide a reference for guiding treatment. MethodsThe clinical data of 50 patients with lung cancer complicated with malignant hydrothorax and 30 patients with hypoproteinemia complicated with hydrothorax or cardiac failure complicated with hydrothorax, who were treated in our hospital from January 2017 to February 2019, were retrospectively analyzed. The contents of sST2 and Fascin, and the expression levels of cancer cell malignant proliferation and invasion genes in the hydrothorax were compared between the two groups. Pearson correlation analysis was performed on patients with lung cancer to analyze the contents of sST2 and Fascin and the expression levels of cancer cell malignant proliferation and invasion genes in the hydrothorax. ResultsCompared to the control group, the study group yielded higher contents of sST2 and Fascin, higher expressions of the hydrothorax cancer cell malignant proliferation genes in BCL2 and KI-67, lower expressions of LKB1 and MTS1, higher expressions of the hydrothorax cancer cell malignant invasion genes in MMP9 and N-cadherin, whereas lower expressions of E-cadherin, TMSG-1 and Bin-1, with statistically significant differences (P＜0.05). Pearson correlation analysis results showed that the contents of sST2 and Fascin in the hydrothorax of the study group were negatively correlated with the expression levels of the malignant proliferation genes LKB1, MTS1, and the malignant invasion genes E-cadherin, TMSG-1 and Bin-1 in the cancer cells inthe hydrothorax, whereas were positively correlated with the expression levels of malignant proliferation genes BCL2, KI-67, and malignant invasion genes MMP9 and N-cadherin. ConclusionThe contents of sST2 and Fascin, the expression levels of malignant proliferation genes BCL2, KI-67 and malignant invasion genes MMP9 and N-cadherin in the hydrothorax of the patient are closely related to the properties of the hydrothorax in patients, which has important reference value for defining the properties of hydrothorax, and for conducting the correct diagnosis and treatment in patients.