血清SCML2在胃肠胰神经内分泌肿瘤中的表达及临床意义  

The expression and clinical significance of serum SCML2 in gastrointestinal and pancreatic neuroendocrine tumors

作　　者：李梅[1] 马剑波[1] 吴芸妤 纪易斐[3] 肖明兵[3] 钱坤艳 LI Mei;MA Jianbo;WU Yunyu;JI Yifei;XIAO Mingbing;QIAN Kunyan(Department of Medical Oncology,Affiliated Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学附属医院肿瘤科,江苏南通226001 [2]南通大学医学院临床医学系,226001 [3]南通大学附属医院消化内科,226001 [4]南通市崇川区疾病预防控制中心检验科,226007

出　　处：《临床肿瘤学杂志》2020年第3期251-256,共6页Chinese Clinical Oncology

基　　金：江苏省重点研发面上项目(BE2019692);南通市科技计划资助项目(MS22018006);南通市科技计划指导性项目(MSZ19227)。

摘　　要：目的探讨血清SCML2蛋白在胃肠胰神经内分泌肿瘤(GEP-NENs)中的表达及临床意义。方法收集南通大学附属医院2009年1月至2014年1月GEP-NENs组织和血清标本64例,另外收集同时期胃、肠、胰腺癌(均为腺癌)和胃肠息肉手术患者各30例组织和血清标本。采用TRFIA法检测血清SCML2水平,采用免疫组化法检测组织中SCML2蛋白表达。分析血清SCML2表达与GEP-NENs临床病理特征及预后的关系。结果GEP-NENs患者血清SCML2蛋白表达量[(62.50±34.0)ng/ml]明显高于腺癌患者[(24.89±15.32)ng/ml]、胃肠息肉患者[(21.83±16.49)ng/ml],差异具有统计学意义(P<0.05);且血清SCML2蛋白表达与病理类型、病理分级、浸润深度、TNM分期有关(P<0.05)。GEP-NENs患者血清SCML2水平与血清CgA水平(r=0.649,P<0.05)、组织SCML2蛋白表达(r=0.814,P<0.05)呈正相关。ROC曲线分析,血清SCML2诊断GEP-NENs的效能高于血清CgA[0.871(95%CI:0.812~0.930)vs.0.714(95%CI:0.624~0.804)]。GEP-NENs患者随访时间为2~125个月,中位生存时间(OS)为48.0个月(37.6~58.4个月),其中血清SCML2低表达患者中位OS为89.0个月(29.2~148.8个月),高于血清SCML2高表达患者中位OS为42.0个月(28.2~55.9个月),差异有统计学差异(χ^2=9.442,P=0.002)。结论血清SCML2在GEP-NENs患者中的表达量明显升高,与病理类型、病理分级、浸润深度、TNM分期、预后不良有关。Objective To investigate the expression and clinical significance of serum sex comb on midleg like-2(SCML2)in gastrointestinal and pancreatic neuroendocrine tumors(GEP-NENs).Methods From January 2009 to January 2014,64(GEP-NENs tissue and serum samples were collected from the Affiliated Hospital of Nantong University.In addition,30 tissue and serum samples were collected from patients with gastric cancer,intestinal cancer,pancreatic cancer and 30 patients with gastrointestinal polyp operation at the same time.Serum SCML2 level was detected by TRFIA method,and the expression of SCML2 protein in tissues was detected by immunohistochemistry.The relationship between the expression of SCML2 in serum and the clinicopathological characteristics of GEP NENS and the prognosis was analyzed.Results The serum SCML2 level in GEP-NENs patients was(62.50±34.0)ng/ml,higher than that in adenocarcinoma patients[(24.89±15.32)ng/ml]and gastrointestinal polyp patients[(21.83±16.49)ng/ml]the difference was statistically significant(P<0.05).The expression of serum SCML2 in GEP-NENs was related to pathological type,pathological grade,infiltration depth and TNM stage(P<0.05).There was a positive correlation between serum SCML2 and CgA(r=0.649,P<0.05)and SCML2 protein expression(r=0.814,P<0.05).ROC curve analysis showed that SCML2 was more effective than CgA in the diagnosis of GEP-NENs.The follow-up time of GEP-NENs was 2-125 months,and the median survival time(OS)was 48.0 months(37.6-58.4 months).The median OS of patients with low SCML2 expression was 89.0 months,which was higher than that of patients with high SCML2 expression.The difference was statistically significant(P=0.002).Conclusion The expression of SCML2 in GEP-NENs was significantly increased,which was related to tumor pathological type,pathological grade,depth of invasion,TNM stage and poor prognosis.

关 键 词：胃肠胰神经内分泌肿瘤(GEP-NENs) SEX COMB on midleg like-2(SCML2) 时间分辨荧光免疫检测法(TRFIA) 嗜铬粒素A(CgA) 预后 

分 类 号：R735[医药卫生—肿瘤]