中国普通外科杂志2026，Vol.35Issue(4)：787-794,8.DOI:10.7659/j.issn.1005-6947.250386
术前血清c-Myc和GINS4对胃癌根治术患者预后的联合预测价值
Combined prognostic value of preoperative serum c-Myc and GINS4 in patients undergoing radical gastrectomy for gastric cancer
摘要
Abstract
Background and Aims:Prognostic heterogeneity remains substantial among patients undergoing radical gastrectomy for gastric cancer,while conventional TNM staging is insufficient to fully reflect tumor biological behavior.This study aimed to investigate the prognostic value of preoperative serum c-Myc and GINS complex subunit 4(GINS4)levels and their combined detection in patients undergoing radical gastrectomy for gastric cancer. Methods:A total of 180 patients who underwent radical gastrectomy for gastric cancer between January 2019 and January 2022 at Jinan No.4 People's Hospital were retrospectively collected,and 50 healthy individuals undergoing health maintenance examination were included as controls.Serum c-Myc and GINS4 levels were measured using double-antibody sandwich ELISA.Patients were classified into double high-expression,single high-expression,and double low-expression groups according to cutoff values of c-Myc and GINS4 levels.Kaplan-Meier analysis was performed to compare survival outcomes among groups.Cox proportional hazards regression analysis was used to identify independent prognostic factors.Receiver operating characteristic(ROC)curves were constructed to evaluate predictive efficacy. Results:Serum c-Myc and GINS4 levels were significantly elevated in gastric cancer patients compared with controls(both P<0.001).The overall 3-year survival rate was 58.3%.Patients in the double high-expression group had a median survival time of 24 months and a 3-year survival rate of 25.58%,which were significantly worse than those in the single high-expression and double low-expression groups(both P<0.001).Univariate analysis showed that TNM stage,lymph node metastasis,serum c-Myc level,and serum GINS4 level were associated with prognosis(all P<0.05).Multivariate Cox regression analysis identified TNM stage,c-Myc,and GINS4 as independent prognostic factors(all P<0.05).ROC analysis demonstrated that the combination of TNM stage,c-Myc,and GINS4 achieved an AUC of 0.875,which was superior to each individual indicator alone. Conclusion:Elevated preoperative serum c-Myc and GINS4 levels are closely associated with poor prognosis in patients undergoing radical gastrectomy for gastric cancer.Combined detection of these two biomarkers shows favorable prognostic predictive performance and may serve as a potential serological marker for postoperative risk stratification and prognostic assessment.关键词
胃肿瘤/原癌基因蛋白质c-Myc/GINS复合物4/预后Key words
Stomach Neoplasms/Proto-Oncogene Proteins c-Myc/GINS Complex Subunit 4/Prognosis分类
医药卫生引用本文复制引用
赵资文,张乃顺,刘兆礼..术前血清c-Myc和GINS4对胃癌根治术患者预后的联合预测价值[J].中国普通外科杂志,2026,35(4):787-794,8.基金项目
山东省医药卫生科技发展计划基金资助项目(202104010373). （202104010373）
