复发性鼻咽癌患者血清sCD44s、MIP⁃3α水平及与经鼻内镜治疗疗效的相关性  

The changes of serum sCD44s and MIP⁃3α levels in patients with recurrent nasopharyngeal carcinoma and their correlation with the therapeutic effect of endoscopic sinus surgery

作　　者：胡金成 黄妙铭[1] 毛志强[1] 蒋迪[1] 叶宇东 傅明[1] HU Jincheng;HUANG Miaoming;MAO Zhiqiang;JIANG Di;YE Yudong;FU Ming(Department of Otolaryngology,Dongguan People's Hospital,Dongguan,Guangdong,China,523000)

机构地区：[1]东莞市人民医院耳鼻咽喉科,广东东莞523000

出　　处：《分子诊断与治疗杂志》2022年第4期614-617,622,共5页Journal of Molecular Diagnostics and Therapy

基　　金：2020年东莞市社会科技发展(一般)项目(202050715001775)。

摘　　要：目的探讨复发性鼻咽癌(NPC)患者血清可溶性标准CD44(sCD44s)、巨噬细胞炎性蛋白⁃3α(MIP⁃3α)水平变化及与经鼻内镜治疗疗效的相关性。方法选取2018年6月至2021年1月东莞市人民医院耳鼻咽喉科26例复发性NPC患者作为观察组,另选取26例NPC治疗后放射性颅底骨坏死患者(无复发)作为对照组。对比两组临床资料、血清sCD44s、MIP⁃3α水平变化,分析复发性NPC影响因素及血清sCD44s、MIP⁃3α水平与临床病理特征的关系,绘制受试者工作曲线(ROC)评价血清sCD44s、MIP⁃3α水平对复发性NPC的预测价值,并对比联合预测阳性、阴性患者经鼻内镜治疗远期疗效。结果两组年龄、T分期、N分期、临床分期及初治后血清sCD44s、MIP⁃3α水平相比,差异有统计学意义(P<0.05);Logistic回归分析显示,年龄、T分期、N分期、临床分期、初治后血清sCD44s、MIP⁃3α水平均为复发性NPC影响因素(P<0.05);复发性NPC患者初治后血清sCD44s、MIP⁃3α水平与T分期、N分期及临床分期呈正相关关系(P<0.05);ROC曲线显示,血清sCD44s、MIP⁃3α水平(初治后)联合预测复发性NPC的AUC最大,为0.939,具有良好预测效能,最佳敏感度、特异度分别为80.77%、96.15%;联合预测阳性患者1年病死率高于阴性患者,差异有统计学意义(P<0.05)。结论初治后血清sCD44s、MIP⁃3α与NPC复发及临床病理特征有关,联合检测可有效预测复发性NPC,且对NPC经鼻内镜治疗疗效有一定预测价值,为及时采取有效、个体化治疗提供依据。Objective To investigate the changes in serum soluble CD44 standard(sCD44s)and macrophage inflammatory protein⁃3α(MIP⁃3α)levels in patients with recurrent nasopharyngeal carcinoma(NPC)and their correlation with the therapeutic efficacy of endoscopic sinus surgery.Methods From June 2018 to January 2021,26 patients with recurrent NPC in our hospital were selected as the observation group,and 26 patients with radioactive skull base osteonecrosis(without recurrence)after NPC treatment were selected as the control group.The clinical data,serum levels of sCD44s and MIP⁃3αwere compared between the two groups.The influencing factors of recurrent NPC and the relationship between serum sCD44s and MIP⁃3αlevels and clinicopathological characteristics were analyzed.A receiver operating curve(ROC)was drawn to evaluate the predictive value of serum sCD44s and MIP⁃3αlevels for recurrent NPC.The long⁃term effects of combined nasal endoscopic treatment of patients with positive and negative predictions were compared.Results There were statistically significant differences between the two groups in age,T stage,N stage,clinical stage and serum sCD44s and MIP⁃3αlevels after initial treatment(P<0.05).Logistic regression analysis showed that age,T stage,N stage,clinical stage,serum sCD44s and MIP⁃3αlevels after initial treatment were all influencing factors for recurrent NPC(P<0.05).Serum sCD44s and MIP⁃3αlevels in patients with recurrent NPC after initial treatment were positively correlated with T stage,N stage and clinical stage(P<0.05).The ROC curve showed that the combination of serum sCD44s and MIP⁃3αlevels(after initial treatment)had the largest AUC for predicting recurrent NPC,which was 0.939,which had good predictive effect.The best sensitivity and specificity were 80.77%and 96.15%respectively.The 1⁃year mortality rate of combined predictive positive patients was higher than that of negative patients,and the difference was statistically significant(P<0.05).Conclusion After initial treatment,serum

关 键 词：复发性鼻咽癌 可溶性标准CD44 巨噬细胞炎性蛋白⁃3α 鼻内镜 

分 类 号：R739.63[医药卫生—肿瘤]