软组织肉瘤患者可溶性ST2的临床价值:一项单中心横断面研究

Clinical value of soluble ST2 in patients with soft tissue sarcomas:a single center cross-sectional study

背景与目的:可溶性肿瘤抑制因子2(soluble suppression of tumorigenicity2,sST2)是反映心肌肥厚和心肌纤维化的生物标志物。探讨软组织肉瘤患者sST2检测的临床价值。方法:横断面收集2019年7—8月在复旦大学附属中山医院接受治疗的软组织肉瘤患者的临床信息,包括人口统计学特点、软组织肉瘤分类分期、心血管疾病类型。收集患者治疗前血清sST2、乳酸脱氢酶(lactate dehydrogenase,LDH)和D-二聚体(D-dimer)、高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、心肌肌钙蛋白(cardiac troponin T,cTnT)和氨基末端脑钠肽前体(amino terminal pro-brain natriuretic peptide,NT-proBNP)检测结果,以及超声心动图左心室射血分数(left ventricular ejection fraction,LVEF)。采用SPSS 21.0统计软件进行分析。结果:共收集软组织肉瘤患者64例,包括男性29例,女性35例,平均年龄(45.9±14.6)岁。其中具有心血管疾病史患者12例、糖尿病2例。sST2、LDH、D-dimer、NT-proBNP、hs-CRP、cTnT指标经自然对数转换后符合正态分布。以lnsST2为因变量,各指标自然对数转换后数据和LVEF为自变量进行单因素Spearman相关线性分析显示,sST2与LDH、D-dimer、hs-CRP、NT-proBNP存在相关性,差异有统计学意义(P均<0.01)。进一步将以上自变量纳入sST2多因素线性回归分析,回归方程中LDH偏回归系数差异有统计学意义(P=0.01)。结论:在心功能相对正常的软组织肉瘤患者中,sST2有望成为新型肿瘤标志物。

Background and purpose:Soluble suppression of tumorigenicity2(sST2)is a biomarker of myocardial hypertrophy and myocardial fibrosis.This study aimed to investigate the clinical value of sST2 in patients with soft tissue sarcomas.Methods:A cross-sectional survey was conducted in the patients with soft tissue sarcomas treated in Zhongshan Hospital,Fudan University from Jul.2019 to Aug.2019.The data were collected,including demographic characteristics,soft tissue sarcoma staging and combined cardiovascular disease.Serum sST2,lactate dehydrogenase(LDH),D-dimer,high-sensitivity C-reactive protein(hs-CRP),cardiac troponin T(cTnT)and N-terminal pro-brain natriuretic peptide(NT-proBNP)were tested in the laboratory before treatment.Data of left ventricular ejection fraction(LVEF)were collected via echocardiography.Results:A total of 64 patients with soft tissue tumor were enrolled,including 29 males and 35 females,average age of 45.9±14.6 years.There were 12 patients with medical history of cardiovascular disease and 2 patients with diabetes mellitus.After natural logarithm transformation,ST2,LDH,D-dimer,NT proBNP,hs-CRP and cTnT were in accordance with normal distribution.Single factor Spearman correlation linear analysis showed that sST2 was highly correlated with LDH,D-dimer,hs-CRP and NT-proBNP(P<0.01).Furthermore,the above independent variables were included in the multiple factor linear regression analysis of sST2.The results showed that sST2 had a high correlation with LDH.Conclusion:In patients with soft tissue sarcomas and relatively normal cardiac function,sST2 is expected to become a new tumor marker.