鼻咽癌细胞间粘附分子-1升高的临床意义

Clinical significance of elevated serum sICAM-1 in patients with nasopharyngeal carcinoma

目的 探讨鼻咽癌血清细胞间粘附分子 1(intercellularadhesionmolecule 1,ICAM 1)和组织ICAM 1表达及其意义。方法 免疫组化和酶联免疫吸附测定 (enzyme linkedimmunosorbentassay ,ELISA)方法检测 5 4例鼻咽癌组织ICAM 1表达及血清可溶性ICAM 1(solubleICAM 1,sICAM 1)水平。设对照组 2 0例。结果 鼻咽癌组织ICAM 1阳性表达 (4 5 / 5 4)与血清sICAM 1质量浓度 (2 0 44 48±6 40 0 5 ) μg/L明显高于对照组的 2 / 2 0与 (313 70± 114 98) μg/L(P <0 0 1)。癌组织ICAM 1表达和血清sICAM 1质量浓度密切相关 (P <0 0 5 )。血清sICAM 1质量浓度与病期及淋巴结转移有关 (P值均<0 0 5 )。治疗后sICAM 1质量浓度 (92 6 5 5± 2 0 7 72 ) μg/L比治疗前 (2 2 11 42± 717 5 9) μg/L明显降低但仍比对照组高 (P <0 0 1)。治疗后 6个月肿瘤全消者sICAM 1质量浓度仍呈低水平 (82 1 42±2 16 5 2 ) μg/L ,而肿瘤部分残留者复又上升至 (12 6 8 45± 2 2 8 32 ) μg/L (P <0 0 1)。 结论 鼻咽癌存在与sICAM 1相关的抗肿瘤细胞免疫应答异常 ,血清sICAM 1检测可以反映肿瘤细胞逃逸机体免疫监视的能力 ,可作为判断鼻咽癌发展程度及疗效评价和随访监测病情变化的一项血清学指标。

Objective To study the expression of serum sICAM-1(soluble intercellular adhesion molecule-1) and tissue ICAM-1 in nasopharyngeal carcinoma and its clinical significance Methods Expression of ICAM-1 in frozen sections of 20 normal nasopharyngeal mucosa and 54 nasopharyngeal carcinoma samples were studied with immunohistochemical technique, and levels of serum sICAM-1 in 54 patients with nasopharyngeal carcinoma (NPC group) and 32 healthy adults (normal group) by ELISA Results Positive expression (45/54) of tissue ICAM-1 and levels (2 044 48±640 05) μg/L of serum sICAM-1 in NPC group were significantly higher than that of 2/20 and (313 70±114 98) μg/L in normal group ( P <0 01,respectively), and there was a positive relationship between the expression of tissue ICAM-1 and levels of serum sICAM-1 in nasopharyngeal carcinoma( P <0 05) The levels (2 177 31±642 13) μg/L of serum sICAM-1 in patients with III-IV stages were higher than those (1 847 25 ±308 15) μg/L in I-II stages ( P <0 05), and those (1 678 89±685 01) μg/L in patients with no lymph node metastasis lower than that (2 134 34±609 60) μg/L in lymph node metastasis ( P <0 05) The levels of serum sICAM-1 decreased significantly from (2 211 42±717 59) μg/L to (926 55±207 72) μg/L in disappearance of tumor and metastatic lymph node after radiotherapy ( P <0 01) Conclusion sICAM-1 might be involved in the cellular immunopathogenesis of nasopharyngeal carcinoma, and the measurement of the serum sICAM-1 may reflect ability of neoplasm cell in freedom from host immunological surveillance Dynamic measurement of serum sICAM-1 may be a useful objective index to evaluate NPC prognosis and curative effects