关键词: 范可尼蛋白, 结直肠癌, 复发, 转移, 危险因素, 预测价值

Abstract: Objective To investigate the relationship between Fanconi anemia complementation group I (FANCI) expression in primary focus of colorectal cancer (CRC) and early postoperative recurrence and metastasis.Methods 183 patients with CRC admitted to Wuhan University of Science and Technology Affiliated Puren Hospital from January 2022 to February 2024 were selected for the study.All patients underwent 12-month postoperative follow-up.After excluding those lost to follow-up,they were categorised into a recurrence-free group (128 cases) and a recurrence-metastasis group (50 cases) based on the occurrence of recurrence or metastasis.The general data and the expression level of FANCI in the primary focus were compared between the two groups.The Cox proportional hazard model was used to analyze the risk factors of early postoperative recurrence and metastasis in CRC patients.Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of FANCI expression level for recurrence and metastasis.ResultS The tumor diameter in the recurrence and metastasis group was (5.91±1.08) cm,which was larger than that in the non-recurrence and metastasis group [(4.29±0.85) cm].The number of lymph node metastases was (4.40±1.19),which was more than that in the non-recurrence and metastasis group [(2.94±0.87)].The proportion of patients in INM stage Ⅲ was 50.00%,the serum carcinoembryonic antigen (CEA) level was (9.18±2.79)ng/ml,the carbohydrate antigen 199(CA199) level was (29.71±9.47)U/ml,and the positive rate of FANCI was 94.00%.They were all higher than the non-recurrence and metastasis group[ 25.00%,(5.27±1.44)ng/ml,(21.65±8.51)U/ml,and 61.72%],and the differences were statistically significant (P<0.05).The Cox analysis showed that large tumor diameter,a large number of lymph node metastases,high serum CEA level,TNM stage III,and positive FANCI expression were risk factors affecting early postoperative recurrence and metastasis in CRC patients (P<0.05).ROC analysis showed that the AUC of FANCI(+),FANCI(++ )and FANCI(+++) in predicting early postoperative recurrence and metastasis of CRC patients were 0.716,0.865 and 0.725,respectively,and FANCI(++) predicted the highest AUC (P<0.05).Conclusion The positive expression of FANCI in the primary focus of CRC patients is a risk factor for early postoperative recurrence and metastasis.When FANCI(++) is taken as the cutoff value,the prediction efficiency of postoperative recurrence and metastasis is the strongest.

Key words: Fanconi protein, colorectal cancer, recurrence, transfer, risk factors, predicted value