鼻咽癌患者血清MIP-3α与cystatin A表达及其临床意义

Expression of serum MIP-3α and cystatin A in patients with nasopharyngeal carcinoma and their clinical significance

背景与目的:目前,检测鼻咽癌的病灶残留、复发、远处转移,评价放化疗敏感性及判断预后主要依赖影像学的检查。寻找鼻咽癌早期诊断及预后相关的特异性分子标志物对鼻咽癌的早期诊断及个体化治疗具有重要意义。本研究通过检测血清巨噬细胞炎性蛋白-3α(macrophage inflammatory protein-3α,MIP-3α)和cystatin A蛋白在鼻咽癌患者治疗前、后及健康人中的表达情况,探讨其在鼻咽癌诊断、与临床病理特征关系以及疗效评价中的作用。方法:应用定量酶联免疫吸附法检测140例初治无远处转移的鼻咽癌患者治疗前、治疗结束后血清中MIP-3α和cystatin A的表达情况,并以100名健康体检者为对照。结果:以血清MIP-3α水平为31 pg/mL及cystatin A水平为16 ng/mL诊断鼻咽癌的敏感度分别为92.1%及42.1%,特异度分别为86.0%及85.0%。140例鼻咽癌患者经过治疗后均达到完全缓解或者部分缓解。鼻咽癌患者治疗前血清MIP-3α和cystatin A水平显著高于治疗后和健康对照者。MIP-3α和cystatin A均与鼻咽癌临床分期相关,MIP-3α还与T分期有关。治疗后完全缓解患者的血清MIP-3α降至健康对照者水平。部分缓解患者仍高于健康对照者水平,而完全缓解与部分缓解患者的血清cystatin A均降至健康对照者水平。在1年内发生远处转移的患者治疗后血清MIP-3α和cystatin A水平均明显高于未发生远处转移患者和健康对照者。MIP-3α和cystatin A表达之间存在相关性。结论:血清MIP-3α水平作为辅助诊断鼻咽癌的指标有一定的临床意义。血清MIP-3α与cystatin A检测有助于判断鼻咽癌分期和治疗后的近期疗效。

Background and purpose： To date, it mainly depended on imaging examination for detection of residual lesions, recurrence and distant metastasis, evaluation the sensitivity of radiotherapy and chemotherapy, and prognosis in nasopharyngeal carcinoma （NPC）. Thus, searching for new tumor markers for NPC early diagnosis and individualized treatment is still merited. This study was aimed to investigate the expressions of serum macrophageinflammatory protein （MIP）-3α and cystatin A in patients with NPC before and after treatment, and to explore two markers＇ value in NPC diagnosis, clinicopathological characteristics and clinical outcome assessment. Methods： The serum levels of MIP-3α and cystatin A in 140 primary NPC patients without distant metastasis before and after treatment were detected by enzyme-linked immunosorbent assay （ELISA） and compared with those in 100 healthy controls. Results： The sensitivity of MIP-3α and cystatin A were 92.1% and 42.1%, respectively; and the specificity of MIP-3tt and cystatin A were 86.0% and 85.0%, respectively. All 140 NPC patients had complete remission （CR） or partial remission （PR）. Serum levels of MIP-3α and cystatin A in pre-treatment patients with NPC were higher than those in post-treatment patients and controls. Serum MIP-3α and cystatin A levels were associated with overall stage of NPC, and MIP-3α was also associated with T classification of NPC. The serum MIP-3α level in NPC with CR after treatment reduced to the level in control group, and that was still significantly higher in NPC with PR than in control group. No significant difference was found in the serum cystatin A level between NPC with CR or PR after treatment and control group. During 1-year follow-up, the post-treatment serum levels of MIP-3α and cystatin A were significantly higher in patients with distant metastasis than in patients without distant metastasis and controls. There was found statistically significant correlation between MIP-3α and cystatin A.Conelusion： MIP-3α may be a potential marker of NPC serological diagnosis. The detection of serum MIP-3α and cystatin A may contribute to the NPC staging and prediction of short-term clinical outcomes.