CAFs联合LVD对早期宫颈鳞癌淋巴结转移的预测价值  

Predictive effect of CAFs combined LVD on lymph node metastasis in early-stage cervical squamous cell carcinoma

作　　者：黄晓岚 魏文斐 陈晓静 王梓慈 郭楚鸿 陈佩玉 王薇[1] Huang Xiaolan;Wei Wenfei;Chen Xiaojing(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120;Zhuhai People's Hospital,Zhuhai 519000)

机构地区：[1]广州医科大学附属第一医院妇产科,广州510120 [2]珠海市人民医院,珠海519000

出　　处：《现代妇产科进展》2023年第4期241-247,共7页Progress in Obstetrics and Gynecology

基　　金：国家自然科学基金青年项目(No:82102685);广州市科技计划项目(No:202120120936)。

摘　　要：目的:探讨肿瘤相关成纤维细胞(CAFs)联合淋巴管密度(LVD)对早期宫颈鳞状细胞癌(CSCC)淋巴结转移(LNM)的预测价值。方法:利用免疫组化及多重免疫荧光检测132例早期CSCC组织标本(手术切除标本92例,活检组织标本40例)中α-SMA+CAFs和D2-40+LVs表达水平。分析CAFs密度与LVD的相关性,并与临床病理资料进行相关性统计学分析。建立logistic回归模型,绘制受试者工作特征曲线(ROC)分析CAFs和LVD对早期CSCC淋巴结转移的预测价值,将手术标本的病理评估结果与术前活检结果进行比较,以明确活检标本的预测效果。结果:92例手术切除标本中,早期CSCC组织的CAFs密度与LVD呈正相关(Spearman’s rho=0.597,P<0.001),CAFs密度和LVD均与LNM、淋巴脉管浸润(LVI)密切相关(P<0.05)。ROC分析显示,与LVD单独诊断LNM相比,CAFs密度联合LVD具有更高的敏感性(84.40%vs 71.90%,P<0.05)和相当的特异性(96.70%vs 98.30%,P>0.05)。CAFs密度与LVD结合具有最大的AUC(0.958,95%CI=0.919~0.997)。40例活检组织标本中,CAFs密度与LVD呈正相关(Spearman’s rho=0.487,P<0.001),二者表达水平在LNM组均高于non-LNM组(P<0.05)。活检标本与术后病理诊断淋巴结转移的总符合率为97.5%。结论:联合检测早期CSCC组织的CAFs密度、LVD水平在预测早期CSCC淋巴结转移中具有重要参考价值。Objective:To investigate the predictive value of cancer-associated fibroblasts(CAFs)combined with lymphatic vessel density(LVD)in lymph node metastasis(LNM)of early-stage cervical squamous cell carcinoma(CSCC).Methods:The expressions ofα-SMA+CAFs and D2-40+LVs were determined by immunohistochemistry and multiplexed immunofluorescence in the tissue samples of 132 patients with early-stage CSCC(92 surgical resection specimens and 40 biopsy specimens).The correlation of CAFs density with LVD was analyzed,and correlative statistical analyses with clinicopathological data were also performed.A logistic regression model was established,the predictive value of CAFs and LVD for LNM was assessed using receiver operating characteristic curves(ROC).Findings from preoperative biopsies were compared with findings on pathologic evaluation of surgical specimens to determine the performance of biopsy in predicting LNM.Results:In the 92 surgical specimens of early-stage CSCC,CAFs density was positively correlated with LVD(Spearman's rho=0.597,P<0.001).We showed that CAFs density and LVD were associated with LNM and lymphovascular invasion(LVI)(P<0.05).ROC analysis showed that CAFs density combined with LVD had higher sensitivity(84.40%vs 71.90%,P<0.05)and a considerable specificity(96.70%vs 98.30%,P>0.05)than LVD alone in diagnosing LNM.The CAFs density combined with LVD also had the highest AUC(0.958,95%CI=0.919~0.997).In the 40 surgical specimens,CAFs density was positively correlated with LVD(Spearman's rho=0.487,P<0.001).The levels of CAFs density and LVD were higher in LNM group than the non-LNM group(P<0.05).Moreover,a total coincidence rate of 97.5%was observed between biopsy specimens and postoperative pathological diagnosis of LNM.Conclusions:Combined detection of CAFs density and LVD may have an important implication for predicting LNM in early-stage CSCC.

关 键 词：宫颈鳞状细胞癌 肿瘤相关成纤维细胞 淋巴管密度 淋巴结转移 

分 类 号：R737.33[医药卫生—肿瘤]