外周血CD59,LGR5和CK7水平表达对宫颈癌前病变进展风险的预测价值研究  

Predictive Value of Combined Detection of Peripheral Blood CD59,LGR5 and CK7 on the Risk of Progression of Cervical Precancerous Lesions

作　　者：李杨[1] 刘文杰 郭莉[1] LI Yang;LIU Wenjie;GUO Li(Department of Gynaecology and Obstetrics,the Third Hospital of Xi’an/Affiliated Hospital of Northwest University,Xi’an 710016,China)

机构地区：[1]西北大学附属医院/西安市第三医院妇产科,西安710016

出　　处：《现代检验医学杂志》2023年第5期105-109,126,共6页Journal of Modern Laboratory Medicine

基　　金：陕西省医学科学研究课题计划(2019JM1844):外周血CD59,LGR5,CK7在癌前病变进展至宫颈癌的预测价值研究。

摘　　要：目的 探讨联合检测外周血CD59,血富含亮氨酸重复序列的G蛋白偶联受体5(leucine-repeat-rich G-protein coupled receptor 5,LGR5)和细胞角蛋白7(cytokeratin 7,CK7)对宫颈癌前病变进展风险的预测价值。方法 回顾性分析2019年1月~2022年1月西安市第三医院收治的342例宫颈癌前病变患者的临床资料,根据病情进展情况分为宫颈上皮内瘤变(cervical intraepithelial neoplasias, CIN)Ⅰ组(n=89),CINⅡ组(n=128),CINⅢ组(n=65)和宫颈癌组(n=60)。统计四组一般资料,CD59,LGR5和CK7,Logistic回归方程分析癌前病变进展至宫颈癌影响因素,绘制决策分析(decision curve analysis,DCA)曲线分析CD59,LGR5和CK7联合临床获益度,绘制临床影响曲线(clinical impact curve,CIC)分析在各个阈概率下,CD59,LGR5和CK7联合预测价值与实际情况符合度。结果 宫颈癌组、CINⅢ组、CINⅡ组和CINⅠ组患者HPV感染率(50.00%,7.70%,1.56%,0.00%)及外周血CD59蛋白(55.35%±6.38%,46.17%±5.12%,42.24%±4.13%,38.35%±4.02%),LGR5基因(0.91±0.25,0.38±0.08,0.25±0.06,0.15±0.04),CK7基因(10.12±3.04,7.96±1.55,7.12±1.48,6.50±1.36)表达水平比较,宫颈癌组> CINⅢ组> CINⅡ组>CINⅠ组,差异具有统计学意义(χ^(2)=118.290,F=165.265,567.350,51.982,均P <0.05);Logistic回归显示,CD59(OR:3.483,95%CI:1.614~7.518),LGR5(OR:5.241,95%CI:2.689~10.214),CK7(OR:4.078,95%CI:1.461~11.742)水平是癌前病变患者进展至宫颈癌的高危因素(P <0.05);DCA曲线显示,在0.1~0.45范围内,LGR5,CK7和CD59联合应用具有更高临床获益度;CIC曲线显示,横轴从0.4后,LGR5,CK7和CD59联合预测价值与实际情况具有较高的符合率。结论 LGR5,CK7和CD59是影响癌前病变进展至宫颈癌高危因素,三者联合或可成为预测患者临床获益有效方案,有利于减少宫颈癌发生,增加患者净获益。Objective To investigate the predictive value of the combined detection of peripheral blood CD59,blood leucine-repeat-rich G protein-coupled receptor 5(LGR5),and cytokeratin 7(CK7)on the risk of cervical precancer progression.Methods The clinical data of 342 patients with precancerous lesions in the Third Hospital of Xi’an from January 2019 to January 2022 were retrospectively collected,and they were divided into cervical intraepithelial neoplasia(CIN)I group(n=89),CIN II group(n=128)and CIN III group(n=89)according to their disease progression,and cervical cancer group(n=60).The general data,CD59,LGR5 and CK7 of the four groups were collected.Logistic regression equations were used to analyze the influencing factors of the progression of precancerous lesions to cervical cancer,draw a decision curve analysis(DCA)to analyze the combined clinical benefits of CD59,LGR5,and CK7,draw a clinical impact curve(CIC)to analyze the consistency between the combined predictive value of CD59,LGR5,and CK7,and the actual situation at various threshold probabilities.Results HPV infection rate(50.00%,7.70%,1.56%,0.00%),peripheral blood CD59 molecule(55.35%±6.38%,46.17%±5.12%,42.24%±4.13%,38.35%±4.02%),LGR5(0.91±0.25,0.38±0.08,0.25±0.06,0.15±0.04),and CK7 gene(10.12±3.04,7.96±1.55,7.12±1.48,6.50±1.36)expression levels were compared in the cervical cancer group>CIN III group>CIN II group>CIN I group,and the differences were statistically significant(χ^(2)=118.290,F=165.265,567.350,51.982,all P<0.05).Logistic regression showed that CD59(OR:3.483,95%CI:1.614~7.518),LGR5(OR:5.241,95%CI:2.689~10.214),and CK7(OR:4.078,95%CI:1.461~11.742)levels were high risk factors for progression to cervical cancer in patients with precancerous lesions factor(P<0.05).The DCA curve showed that in the range of 0.1 to 0.45,the combination of LGR5,CK7 and CD59 had a higher clinical benefit.The CIC curve showed that after the horizontal axis changes from 0.4,the joint prediction value of LGR5,CK7 and CD59 has a high coincidence rate with t

关 键 词：癌前病变 宫颈癌 CD59 血富含亮氨酸重复序列的G蛋白偶联受体5 细胞角蛋白7 

分 类 号：R737.33[医药卫生—肿瘤] R730.43[医药卫生—临床医学]