鼻咽癌组织及血清的NRSN2水平及临床意义

Tissues and sera levels of NRSN2 in nasopharyngeal carcinoma and their clinical significance

目的探讨鼻咽癌组织及血清neurensin-2(NRSN2)的水平及临床意义。方法收集本院2014年6月至2016年12月本院诊治的鼻咽癌组织及配对癌旁组织84例、术前血清标本45例及术后血清标本32例,选取同期49例健康体检者的血清作对照。采用实时荧光定量PCR(QPCR)检测癌组织和血清NRSN2水平,比较癌组织与癌旁组织及手术前后血清的NRSN2水平差异,分析鼻咽癌组织NRSN2水平与临床病理特征的关系,进一步采用受试者工作特征曲线(ROC)评价组织NRSN2水平在鼻咽癌早期诊断中的效能。结果 84例鼻咽癌组织的NRSN2水平为11.141±0.801,高于癌旁组织的1.165±0.071,45例鼻咽癌患者的血清NRSN2水平为9.208±0.841,高于49例健康体检者的1.127±0.084,差异有统计学意义(P<0.05);鼻咽癌血清NRSN2水平与组织NRSN2水平呈正相关(r=0.445,P=0.002)。鼻咽癌组织NRSN2水平与性别、年龄、N分期及颈部淋巴结转移无关(P>0.05),而与T分期、TNM分期及VCA-Ig A滴度有关(P<0.05)。32例鼻咽癌患者的术前血清NRSN2水平为10.231±0.979,高于术后的6.907±0.713(P<0.05)。组织NRSN2水平诊断鼻咽癌的曲线下面积为0.954(95%CI:0.891~0.971),最佳截断值为3.490的灵敏度和特异度分别为95.24%和100.0%。结论鼻咽癌患者的组织和血清NRSN2水平均升高,且术后血清NRSN2水平降低,其可能参与了鼻咽癌的发生发展,对鼻咽癌的诊断及病情评估有一定价值。

Objective To investigate the tissues and sera levels of neurensin-2（NRSN2） in nasopharyngeal carcinoma and their clinical significance.Methods From June 2014 to December 2016,84 cases of nasopharyngeal carcinoma tissues and paired adjacent tissues diagnosed and treated in our hospital were collected.Meanwhile,45 preoperative serum samples and 32 postoperative serum samples were collected and serum samples from 49 healthy subjects were used as controls.Real time fluorescent quantitative PCR（QPCR） was used to detect the levels of NRSN2 in cancer tissues and sera.The difference of NRSN2 levels between cancer tissues and adjacent tissues and the difference of serum levels of NRSN2 before and after operation were compared.The relationship between the NRSN2 levels and clinicopathological features in nasopharyngeal carcinoma was analyzed.The receiver operating characteristic curve（ROC） was used to evaluate the efficacy of tissue NRSN2 levels in the early diagnosis of nasopharyngeal carcinoma.Results NRSN2 level was 11.141 ± 0.801 in 84 cases of nasopharyngeal carcinoma,higher than 1.165 ± 0.071 of the adjacent tissues（P 0.05）.The serum level of NRSN2 was 9.208 ± 0.841 in 45 cases of nasopharyngeal carcinoma samples,higher than 1.127 ± 0.084 of49 healthy subjects（P 0.05）.The serum level of NRSN2 was positively correlated with the tissue level of NRSN2 in patients with nasopharyngeal carcinoma（r = 0.445,P = 0.002）.The level of NRSN2 was not correlated with sex,age,N stage and neck lymph node metastasis（P 0.05）,but correlated with T stage,TNM stage and VCA-Ig A titer（P 0.05）.The preoperative serum NRSN2 level of 32 nasopharyngeal carcinoma samples was 10.231 ± 0.979,higher than 6.907 ± 0.713 of postoperative serum samples（P =0.008）.The area under the curve of NRSN2 level was 0.954（95% CI：0.891-0.971）.The optimal cut-off value was 3.490 and the sensitivity and specificity of the cut-off value were 95.24% and 100.0%,respectively.Conclusion In nasopharyngeal carcinoma,the level of NRSN2 was increased,and the serum level of NRSN2 decreased after operation.NRSN2 may participate in the occurrence and development of nasopharyngeal carcinoma.NRSN2 has a certain value in the evaluation and clinical diagnosis of nasopharyngeal carcinoma.