血清SPARC及SERPIND1与鼻咽癌患者放疗敏感性及预后的相关性  

The correlation between serum SPARC,SERPIND1 and radiotherapy sensitivity and prognosis in nasopharyngeal carcinoma patients

作　　者：戴振兴 陈楷 王景芝 周宁 陈伟[1] 刘鸿浩 刘辉 Dai Zhenxing;Chen Kai;Wang Jingzhi;Zhou Ning;Chen Wei;Liu Honghao;Liu Hui(Department of Tumor Radiotherapy,Yancheng First Hospital Affiliated to Nanjing University School of Medicine,Jiangsu Province,Yancheng 224000,China)

机构地区：[1]南京大学医学院附属盐城第一医院肿瘤放疗科,江苏省盐城224000

出　　处：《疑难病杂志》2024年第6期669-674,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：江苏省重点研发计划项目(BE2021643)。

摘　　要：目的研究鼻咽癌(NPC)患者血清富含半胱氨酸的酸性分泌蛋白(SPARC)、纤维蛋白活化因子抑制蛋白(SERPIND1)表达与放疗敏感性及预后的关系。方法收集2017年1月—2019年1月南京大学医学院附属盐城第一医院肿瘤放疗科诊治NPC患者98例为NPC组,选取同期体检的健康人群60例为健康对照组。酶联免疫吸附试验检测血清SPARC、SERPIND1水平。根据NPC患者放疗反应性将NPC患者分为放疗敏感亚组(n=68)和放疗抵抗亚组(n=30)。比较不同临床病理特征、放疗反应的NPC患者血清SPARC、SERPIND1水平差异。绘制Kaplan-Meier曲线,Log-Rank检验比较不同SPARC、SERPIND1表达患者生存预后的差异。采用Cox回归分析NPC预后的影响因素。结果放疗前NPC组患者血清SPARC、SERPIND1水平高于健康对照组(t=37.535、48.522,P均<0.001)。放疗前放疗抵抗亚组NPC患者血清SPARC、SERPIND1水平明显高于放疗敏感亚组(t/P=14.034/<0.001、7.772/<0.001),放疗后2亚组血清SPARC、SERPIND1水平均降低,且放疗敏感亚组低于放疗抵抗亚组(t/P=22.974/<0.001、18.137/<0.001)。肿瘤TNM分期Ⅲ~Ⅳ期、有淋巴结转移NPC患者放疗前血清SPARC、SERPIND1水平高于TNM分期Ⅰ~Ⅱ期、无淋巴结转移者(t/P=16.539/<0.001、16.799/<0.001、15.756/<0.001、15.015/<0.001)。血清SPARC高表达和低表达患者3年总生存率分别为50.00%(24/48)、92.00%(46/50)。血清SERPIND1高表达和低表达患者3年总生存率分别为53.19%(25/47),88.24%(45/51),血清SPARC、SERPIND1高表达NPC患者3年累积生存率明显低于血清SPARC、SERPIND1低表达患者(Log-rankχ^(2)=21.500、14.790,P均<0.001)。TNM分期Ⅲ~Ⅳ期、淋巴结转移、SPARC高表达、SERPIND1高表达是影响NPC预后的独立危险因素[HR(95%CI)=1.608(1.225~2.112)、1.917(1.319~2.799)、1.839(1.228~2.753)、1.738(1.246~2.426)]。结论NPC患者血清SPARC、SERPIND1水平上调,与NPC患者不良临床病理特征及放疗敏感性有关,是评估NPC患者预后的Objective To study the expression of serum secreted protein acidic and rich in cysteine(SPARC),plasmin activator inhibitor 1(SERPIND1)in patients with nasopharyngeal carcinoma(NPC)and their relationship with radiosensitivity and prognosis.Methods Ninety-eight NPC patients diagnosed and treated in the hospital from January 2017 to January 2019 were collected as the NPC group,and 60 healthy individuals who underwent physical examinations during the same period were selected as the control group.Enzyme linked immunosorbent assay was used to detect serum SPARC and SERPIND1 levels.NPC patients were divided into radiation sensitive subgroup and radiation resistant subgroup based on their radiation response.The differences in serum SPARC and SERPIND1 levels among NPC patients with different clinical pathological features and radiation response were compared.Kaplan-Meier curves were drawn and the differences between curves of different SPARC and SERPIND1 expression groups were compared using Log-Rank test.COX regression analysis was used to analyze the prognostic factors of NPC.Results The serum SPARC and SERPIND1 levels in the NPC group before radiotherapy were significantly higher than the control group,the difference was statistically significant(t=37.535,48.522,P<0.001).The serum SPARC and SERPIND1 levels of HPC patients in the radiation resistant subgroup before radiotherapy were significantly higher than those in the radiation sensitive subgroup(t/P=14.034/<0.001,7.772/<0.001).After radiotherapy,the serum SPARC and SERPIND1 levels of the two groups were significantly reduced,and the difference was statistically significant(t/P=22.974/<0.001,18.137/<0.001).The serum SPARC and SERPIND1 levels of NPC patients with TNM stageⅢ-Ⅳand lymph node metastasis before radiotherapy were higher than those of NPC patients with TNM stageⅠ-Ⅱand no lymph node metastasis(t/P=16.539/<0.001,16.799/<0.001,15.756/<0.001,15.015/<0.001).The 3-year overall survival rates of patients with high and low serum SPARC expression were 50.00

关 键 词：鼻咽癌 富含半胱氨酸的酸性分泌蛋白 纤维蛋白活化因子抑制蛋白 放疗敏感性 预后 

分 类 号：R739.62[医药卫生—肿瘤]