联会复合体蛋白2表达水平评估局部晚期宫颈癌患者新辅助化疗效果的应用价值  

Application value of synaptonemal complex protein 2 expression in evaluating the efficacy of neoadjuvant chemotherapy in patients with locally advanced cervical cancer

作　　者：侯忠臣 任琛琛[1] 郭鲁伟 林南山 鲁静荷 任芳[3] 徐臻[4] 朱远航[1] 杨立[1] 申丹丹 HOU Zhongchen;REN Chenchen;GUO Luwei;LIN Nanshan;LU Jinghe;REN Fang;XU Zhen;ZHU Yuanhang;YANG Li;SHEN Dandan(Department of Obstetrics and Gynecology,Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052;Second Clinical Medical School,Zhengzhou University,Zhengzhou 450001;Department of Obstetrics and Gynecology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450002;Department of Obstetrics and Gynecology,Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第三附属医院妇产科,郑州450052 [2]郑州大学第二临床医学院,郑州450001 [3]郑州大学第一附属医院妇产科,郑州450002 [4]郑州大学第二附属医院妇产科,郑州450014

出　　处：《临床与病理杂志》2025年第1期9-17,共9页Journal of Clinical and Pathological Research

基　　金：河南省科技攻关联合项目(LHGJ20230387);河南省科技攻关项目(232102310092);河南省科创中原项目(2023HYTP048)。

摘　　要：目的:联会复合体蛋白2(synaptonemal complex protein 2,SYCP2)是一种睾丸癌相关蛋白质,在多种生殖道恶性肿瘤中呈异常表达,并可能与卵巢癌和乳腺癌化学治疗反应相关。目前,有关SYCP2与局部晚期宫颈癌(locally advanced cervical cancer,LACC)患者新辅助化疗(neoadjuvant chemotherapy,NACT)疗效的相关性研究仍显不足。本研究旨在探讨LACC患者SYCP2表达水平与NACT疗效的关系。方法:选取2021年6月至2024年6月郑州大学第一附属医院、第二附属医院及第三附属医院收治的87例LACC患者为研究对象,并根据患者病理组织切片中SYCP2表达将其分为SYCP2高表达组(n=46)和SYCP2低表达组(n=41)。2组患者术前均接受2个周期的NACT。比较2组患者化学治疗后的近期疗效(客观缓解率)、化学治疗前后血清鳞状上皮细胞癌抗原(squamous cell carcinoma antigen,SCCA)水平变化、生活质量[欧洲癌症研究与治疗组织生活质量核心问卷(European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30,EORTC QLQ-C30)]及不良反应发生情况。结果:免疫组织化学结果显示,正常宫颈组织中SYCP2呈阴性表达,LACC患者肿瘤组织中SYCP2呈阳性表达。SYCP2低表达组患者客观缓解率为80.49%,高于SYCP2高表达组患者的60.87%,差异有统计学意义(P<0.05)。治疗后,2组患者血清SCCA水平均降低,且SYCP2低表达组患者血清SCCA水平低于SYCP2高表达组患者,差异均有统计学意义(均P<0.001)。治疗后,2组患者EORTC QLQ-C30评分均提高,且SYCP2低表达组患者EORTC QLQ-C30评分高于SYCP2高表达组患者,差异均有统计学意义(均P<0.001)。SYCP2低表达组和SYCP2高表达组患者治疗期间III~IV级不良反应发生率分别为36.59%(15/41)和36.96%(17/46),差异无统计学意义(χ2=0.001,P=0.971)。结论:与SYCP2低表达LACC患者相比,LACC患者SYCP2高表达与NACT客观缓解率较低、化学治疗后血清SCCA水平较高及生活质量较低相�Objective:Synaptonemal complex protein 2(SYCP2)is a testis cancer-associated protein that exhibits abnormal expression in various reproductive tract malignancies and may be associated with chemotherapeutic response in ovarian and breast cancers.However,the relationship between the SYCP2 expression and the efficacy of neoadjuvant chemotherapy(NACT)in patients with locally advanced cervical cancer(LACC)remains unclear.This study aims to investigate the association between the SYCP2 expression and NACT efficacy in LACC patients.Methods:A total of 87 LACC patients treated at the First Affiliated Hospital,the Second Affiliated Hospital,and the Third Affiliated Hospital of Zhengzhou University from June 2021 to June 2024 were enrolled and divided into a high SYCP2 expression group(n=46)and a low SYCP2 expression group(n=41)based on the SYCP2 expression in pathological tissue sections.All patients received 2 cycles of NACT before surgery.The short-term efficacy(objective response rate),changes in serum squamous cell carcinoma antigen(SCCA)levels,quality of life[assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30(EORTC QLQC30)],and incidence of adverse events was compared between the 2 groups.Results:Immunohistochemistry showed negative SYCP2 expression in normal cervical tissues and positive SYCP2 expression in tumor tissues of LACC patients.The objective response rate in the low SYCP2 expression group was 80.49%,significantly higher than 60.87%in the high SYCP2 expression group(P<0.05).Post-treatment,serum SCCA levels significantly decreased in both groups,with lower levels observed in the low SYCP2 expression group compared to the high SYCP2 expression group(P<0.001).Post-treatment EORTC QLQ-C30 scores improved in both groups,and the low SYCP2 expression group had significantly higher scores than the high SYCP2 expression group(P<0.001).The incidence of grade III-IV adverse events was similar between the groups:36.59%(15/41)in the low SYCP2 expression group

关 键 词：联会复合体蛋白2 局部晚期宫颈癌 新辅助化疗 同步放化疗 鳞状上皮细胞癌抗原 临床疗效 

分 类 号：R737.33[医药卫生—肿瘤]