宫颈鳞状细胞癌中SMC4、CTLA4表达情况及其早期诊断价值  

Analysis of expression status of SMC4 and CTLA4 in cervical squamous cell carcinoma and their value in early diagnosis

作　　者：高婷婷 王兆林 师增增 李雪峰[1] 梁立 王丽[2] GAO Tingting;WANG Zhaolin;SHI Zengzeng;LI Xuefeng;LIANG Li;WANG Li(Department of Obstetrics and Gynecology,Tangdu Hospital,Air Force Military Medical University of PLA,Xi′an,Shaanxi 710038,China;Xi′an Medical College,Xi′an,Shaanxi 710077,China)

机构地区：[1]中国人民解放军空军军医大学唐都医院妇产科,陕西西安710038 [2]西安医学院,陕西西安710077

出　　处：《检验医学与临床》2023年第4期449-454,共6页Laboratory Medicine and Clinic

基　　金：陕西省自然科学基础研究计划项目(2020JM-604)。

摘　　要：目的分析宫颈鳞状细胞癌中染色体结构维持蛋白4(SMC4)、细胞毒性T淋巴细胞相关抗原4(CTLA4)表达情况及其对预后分析、早期诊断的价值。方法选择2016年1月至2017年1月于中国人民解放军空军军医大学唐都医院(以下简称该院)收治的早期宫颈鳞状细胞癌(国际妇产科联盟分期为ⅠA~ⅡB期)患者112例为观察组,选择同期140例怀疑宫颈疾病,并于该院进行病理检查排除宫颈癌的女性为对照组。采集两组受检者清晨空腹静脉血,采用罗氏Cobas 6000化学发光分析仪检测糖类抗原(CA)125、CA199、癌胚抗原(CEA)、人附睾蛋白-4(HE4)水平。采用免疫组化法检测两组病理组织SMC4、CTLA4表达情况,比较两组受检者临床资料及各项检测指标。采用多因素Logistic回归分析影响宫颈鳞状细胞癌发生的危险因素,采用Kaplan-Meier生存曲线分析不同SMC4、CTLA4表达情况宫颈鳞状细胞癌患者的预后。采用受试者工作特征(ROC)曲线分析SMC4、CTLA4诊断宫颈鳞状细胞癌的效能。结果与对照组比较,观察组宫颈组织SMC4及CTLA4表达评分、CA125、HE4、CA199、CEA水平明显升高,同时观察组有流产史、已绝经女性、首次性交年龄<20岁、首次生育年龄<20岁、孕次>5次、有妇科疾病史患者比例均明显升高,差异有统计学意义(P<0.05)。多因素Logistic回归分析发现,SMC4高表达、CTLA4高表达、有流产史、已绝经、首次性交年龄<20岁、首次生育年龄<20岁、孕次>5次、有妇科疾病史,以及CA125、HE4、CA199、CEA水平升高均为宫颈鳞状细胞癌发生的危险因素(P<0.05)。Kaplan-Meier生存曲线分析结果显示,SMC4高表达患者(61.54%)和CTLA4高表达患者(60.71%)的总生存率分别明显低于SMC4低表达患者(80.00%)和CTLA4低表达患者(82.14%),差异有统计学意义(P<0.05)。ROC曲线分析结果显示,SMC4、CTLA4诊断宫颈鳞状细胞癌的曲线下面积(AUC)分别为0.715、0.752,SMC4+CTLA4诊断宫颈�Objective To analyze the expression changes of chromosome structure maintenance protein 4(SMC4)and cytotoxic T cell molecule 4(CTLA4)in cervical squamous cell carcinoma and their value in prognostic analysis and early diagnosis.Methods A total of 112 patients with early cervical squamous cell carcinoma(International Federation of Obstetrics and Gynecology clinical stageⅠA-ⅡB)admitted to Tangdu Hospital,Air Force Military Medical University of PLA from January 2016 to January 2017 were selected as observation group,140 women suspected of cervical disease who underwent pathological examination in the hospital to exclude cervical cancer were selected as control group.Fasting venous blood of the two groups in the morning was collected and the levels of carbohydrate antigen(CA)125,CA199,carcinoembryonic antigen(CEA)and human epididymal protein-4(HE4)were detected by Roche Cobas 6000 chemiluminescence analyzer.The expressions of SMC4 and CTLA4 in pathological tissues of the two groups were detected by immunohistochemistry,and the clinical data and laboratory detection indexes of the two groups were compared.Multivariate Logistic regression was used to analyze the risk factors of cervical squamous cell carcinoma,and Kaplan-Meier survival curve was used to analyze the prognosis of cervical squamous cell carcinoma with different expressions of SMC4 and CTLA4.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of SMC4 and CTLA4 in cervical squamous cell carcinoma.Results Compared with those in control group,the cervical tissue SMC4 and CTLA4 expression scores,CA125,HE4,CA199 and CEA levels increased significantly in observation group.Meanwhile,the proportion of women with history of abortion,postmenopausal women,age of first sexual intercourse<20 years old,age of first birth<20 years old,the number of pregnancies>5,history of gynecological diseases increased significantly in observation group,the differences were statistically significant(P<0.05).Multivariate Logistic regression anal

关 键 词：宫颈鳞状细胞癌 染色体结构维持蛋白4 细胞毒性T淋巴细胞相关抗原4 

分 类 号：R446.9[医药卫生—诊断学] R737.33[医药卫生—临床医学]