TRAIL/OPG在术前评价食管癌淋巴转移中的价值

The Value of Serum OPG and TRAIL in Preoperative Evaluation of Lymphatic Metastasis of Esophageal Cancer

目的: 研究血清护骨素(OPG)、肿瘤坏死因子相关凋亡诱导配体(TRAIL)与食管癌淋巴转移的关系,探讨其在术前评价食管癌淋巴转移中的价值。 方法: 选取48例食管癌患者为研究对象,其中24例经术后病理明确有淋巴转移的患者为研究组,24例无淋巴转移的患者为对照组。采用ELISA方法检测患者血清中OPG和TRAIL的水平,Western blot方法检测肿瘤组织中caspase蛋白的表达水平。用ROC曲线分析血清OPG、TRAIL水平和TRAIL/OPG比值用于术前评价食管癌有无合并淋巴转移的诊断效能。 结果: 食管癌合并淋巴转移组患者的血清OPG水平显著高于无淋巴结转移组,但血清TRAIL水平和TRAIL/OPG比值均低于无淋巴结转移组,差异有统计学意义(P<0.05)。血清OPG和TRAIL诊断食管癌合并淋巴转移的最佳截断点分别为>0.495pmoL/mL和<0.485pmoL/mL,相应的OPG的敏感度、特异度和准确性分别为91.7%、37.5%和64.6%,TRAIL的敏感度、特异度和准确性分别为75.0%、58.3%和67.0%。而TRAIL/OPG比值在最佳截断点(<0.693)诊断食管癌合并淋巴转移的敏感性、特异性和正确率分别为79.2%、83.3%和81.3%。 结论: TRAIL介导的细胞凋亡途径可能与食管癌的淋巴转移有关,而TRAIL/OPG比值可作为术前评价食管癌淋巴转移的重要辅助指标。

Objective: To investigate the relationship between serumosteoprotegerin (OPG), tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and lymphatic metastasis of esophageal cancer, and to explore its value in preoperative evaluation of lymphatic metastasis of esophageal cancer. Methods: 48 patients with esophageal cancer were selected as the study object, among which 24 patients with lymph node metastasis confirmed by postoperative pathology were the study group, and 24 patients without lymph node metastasis were the control group. The serum levels of OPG and trail were detected by ELISA and caspase protein was detected by Western blot. ROC curve was used to analyze serum OPG, trail and trail / OPG ratio for preoperative evaluation of esophageal cancer with or without lymphatic metastasis. Results: The serum OPG level in esophageal cancer patients with lymphatic metastasis was significantly higher than those without lymph node metastasis, whereas the serum TRAIL level and the ratio of TRAIL/OPG were significantly lower (P<0.05). The best cut-off points of serum OPG and TRAIL for the diagnosis of esophageal cancer with lymphatic metastasis were >0.495pmoL/mL and<0.485pmoL/mL, respectively, with the diagnostic sensitivity, specificity and accuracy of 91.7%, 37.5%, 64.6% and 75.0%,58.3%,67.0%, respectively. The sensitivity, specificity and accuracy of TRAIL/OPG ratio at the best cut-off point (<0.693) for the diagnosis of esophageal cancer with lymphatic metastasis were 79.2%,83.3% and 81.3%, respectively. Conclusion: TRAIL-mediated apoptotic pathway may be related to lymphatic metastasis of esophageal cancer, thus TRAIL/OPG ratio can be a promising auxiliary clinical index for evaluating lymphatic metastasis of esophageal cancer before surgery.