喉鳞癌患者血清氨基酸种类和含量差异与临床价值研究  

Study on the difference and clinical value of serum amino acids in patients with laryngeal squamous cell carcinoma

作　　者：孙洋 干明月 吴勇延 高伟 卢岩 SUN Yang;GAN Mingyue;WU Yongyan;GAO Wei;LU Yan(Department of Otolaryngology Head and Neck Surgery,First Affiliated Hospital of Jinzhou Medical University,Jinzhou,121000,China;Department of Otolaryngology Head and Neck Surgery,Shenzhen Institute of Otorhinolaryngology)

机构地区：[1]锦州医科大学附属第一医院耳鼻咽喉头颈外科,辽宁锦州121000 [2]深圳市龙岗区耳鼻咽喉医院耳鼻咽喉头颈外科深圳市耳鼻咽喉研究所

出　　处：《临床耳鼻咽喉头颈外科杂志》2024年第8期715-721,共7页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：辽宁省教育厅科学技术研究项目青年科技人才“育苗”项目(No:JYTQN2020032);广东省基础与应用基础研究基金(No:2023A1515010342);深圳市科技计划(No:RCJC20210706091950028,JCYJ20220531102815036)。

摘　　要：目的:检测喉鳞状细胞癌患者与非肿瘤患者外周血清中氨基酸种类及含量差异,探讨他们与喉鳞癌各临床参数之间的关系以及在诊断中的临床价值。方法:采用高效液相色谱-串联质谱(HPLC-MS)法检测锦州医科大学附属第一医院2018年9月-2021年2月初诊的62例喉鳞癌患者(实验组)和同时期的141例非肿瘤患者(对照组)血清22种非必需氨基酸及必需氨基酸种类与含量差异,应用ROC曲线及多元线性逻辑回归模型对差异性氨基酸在喉鳞癌早期诊断中的效能进行分析。结果:实验组较对照组血清中有14种氨基酸含量存在差异,其中13种氨基酸含量显著高于对照组(P<0.05),包括7种必需氨基酸:苯丙氨酸、苏氨酸、亮氨酸、缬氨酸、组氨酸、酪氨酸、瓜氨酸,以及6种非必需氨基酸:精氨酸、天冬酰胺、半胱氨酸、甘氨酸、鸟氨酸、脯氨酸。而同型半胱氨酸含量明显低于对照组(P=0.024)。进一步分析表明临床早期(Ⅰ期+Ⅱ期)喉鳞癌患者血清中甲硫氨酸含量显著高于临床晚期(Ⅲ期+Ⅳ期)患者(P=0.026)。高分化鳞状细胞癌患者血清中组氨酸含量显著高于低分化鳞状细胞癌患者(P=0.041)。年龄>64岁的喉鳞癌患者血清中天冬酰胺的含量高于≤64岁的喉鳞癌患者(P=0.033),有吸烟史的喉鳞癌患者血清中色氨酸含量均低于无吸烟史患者(P=0.033),有饮酒史的喉鳞癌患者血清中瓜氨酸含量高于无饮酒史的喉鳞癌患者(P=0.003)。ROC曲线分析表明,实验组与对照组间存在差异的14种氨基酸中,除同型半胱氨酸和鸟氨酸不具备统计学意义(P>0.05),瓜氨酸和半胱氨酸作为独立因素诊断喉鳞癌的效能相对较高(AUC数值分别为0.856及0.850);而精氨酸作为单独诊断喉鳞癌因素时的灵敏度则最高(0.855);但单独使用瓜氨酸诊断喉鳞癌时其特异度最高(0.830);将12种氨基酸联合应用于检测可显著提高喉鳞癌的诊断效能,AUC为0.946,灵敏度�Objective To detect the differences in types and levels of amino acids in the peripheral serum of patients with laryngeal squamous cell carcinoma and non-tumor patients,and explore their relationship with clinical parameters of laryngeal squamous cell carcinoma as well as their clinical value in diagnosis.Methods High-performance liquid chromatography-tandem mass spectrometry(HPLC-MS)was employed to detect the serum amino acid contents and levels of 62 patients diagnosed with laryngeal carcinoma and 141 non-tumor patients at the First Affiliated Hospital of Jinzhou Medical University between September 2018 and February 2021.The study compared the differences in 22 non-essential and essential amino acids found in the serum between the experimental group and the control group.An ROC curve and risk scoring formula of multivariate linear logic regression model was utilized to evaluate the efficiency of serum amino acids in the early diagnosis of laryngeal carcinoma.Results There were significant differences in the contents of fourteen types of amino acids between the experimental and control groups,with thirteen amino acids showing higher levels in the experimental group(P<0.05).Seven of these amino acids were essential,including phenylalanine,threonine,leucine,valine,histidine,tyrosine,and citrulline.The other six amino acids were non-essential,including arginine,asparagine,cysteine,glycine,ornithine,and proline.Interestingly,the content of homocysteine in the experimental group was lower than that in the control group(P=0.024).Further analysis showed that patients with laryngeal squamous cell carcinoma in TNM stageⅠandⅡhad higher serum methionine levels compared to those in stagesⅢandⅣ(P=0.026).In addition,the content of serum histidine was higher in patients with poorly differentiated squamous cell carcinoma compared to those with well-differentiated squamous cell carcinoma(P=0.041).The level of asparagine in the serum of patients with laryngeal squamous cell carcinoma older than 64 years old was lower tha

关 键 词：喉鳞状细胞癌 外周血血清氨基酸 高效液相色谱-串联质谱 诊断效能 

分 类 号：R736.9[医药卫生—肿瘤]