白细胞介素-33和皮肤鳞状细胞癌的相关性研究

Correlation Between Interleukin-33 and Cutaneous Squamous Cell Carcinoma

目的探讨皮肤鳞状细胞癌(CSCC)患者血清和皮损中白细胞介素(IL)-33表达水平及其临床意义。方法纳入2018年1月—2019年8月我院皮肤科64例CSCC患者和40例健康体检者分别作为CSCC组和对照组,采用酶联免疫吸附试验(ELISA)法检测并比较2组研究对象血清中IL-33表达水平的差异;CSCC患者癌组织及其癌旁组织、色素痣患者正常皮肤组织中IL-33蛋白相对表达水平的差异采用Western bolt法检测。采用Logistic回归分析CSCC患者血清中IL-33表达水平的影响因素。利用受试者操作特征曲线(ROC)探讨血清IL-33水平对CSCC患者发生淋巴结或远处转移的诊断价值。结果与对照组[(86.15±15.02)ng/mL]相比,CSCC组[(217.82±23.54)ng/mL]血清IL-33表达水平显著升高,差异有统计学意义(t=31.557,P<0.05)。与CSCC组癌旁组织(0.53±0.04)和正常皮肤组织(0.13±0.01)相比,CSCC组癌组织(1.12±0.13)中IL-33蛋白相对表达水平显著升高,差异有统计学意义(t_(1)=7.538;t2=13.177,P<0.05);CSCC癌旁组织中IL-33蛋白相对表达水平显著高于对照组,差异有统计学意义(t=16.803,P<0.05)。Logistic回归分析结果显示,淋巴结或远处转移(OR=4.369)、组织学分级(OR=3.449)及肿瘤淋巴结转移(TNM)分期(OR=10.444)均是CSCC患者血清IL-33表达水平升高的危险因素。血清IL-33表达水平在诊断CSCC患者存在淋巴结或远处转移的曲线下面积(AUC)为0.834(95%CI:0.743-0.924,P<0.05),当截断值为237.25 ng/mL,此时敏感度和特异度分别为92.14%和86.39%。结论CSCC患者血清及皮损中IL-33表达水平明显升高,IL-33可作为诊断CSCC发生淋巴结或远处转移的一项血清学标志物。

Objective In order to investigate the expression of interleukin(IL)-33 levels in serum and skin lesions of patients with cutaneous squamous cell carcinoma(CSCC)and its clinical significance.Methods A total of 64 patients with CSCC and 40 healthy people in the department of dermatology from January 2018 to August 2019 in our hospital were included and defined as CSCC group and control group,respectively.The differences of serum IL-33 levels in two groups were detected by enzyme-linked immunosorbent assay(ELISA)method and compared.The differences of IL-33 protein expression levels in the CSCC tissue and its adjacent tissue,and the normal skin tissue of patients with nevus were detected by Western bolt method.The influencing factors of serum IL-33 levels in CSCC patients was analyzed by Logistic regression.The diagnostic value of serum IL-33 levels in CSCC complicated with lymph node or distant metastasis by the receiver operating characteristic curve(ROC)method.Results Compared with the control group[(86.15±15.02)ng/mL],the serum IL-33 levels in CSCC group[(217.82±23.54)ng/ml]was significantly higher(t=31.557,P<0.05).Compared with CSCC adjacent tissue(0.532±0.04)and normal skin tissue(0.132±0.01),the IL-33 protein level in CSCC tissue(1.124±0.13)was significantly higher(t_(1)=7.538,t2=13.177,P<0.05).The IL-33 protein level in CSCC adjacent tissue was significantly higher than that in normal skin tissue,the differences were statistically significant(t=16.803,P<0.05).The lymph node or distant metastasis(OR=4.369),histological grade(OR=3.449)and tumor lymph nodes metastasis(TNM)stage(OR=10.444)were the risk factors for the increased serum IL-33 levels in patients with CSCC by Logistic regression results.ROC curve results showed that serum IL-33 level in predicting node or distant metastasis in CSCC was 0.834(95%CI:0.743-0.924,P<0.05).When the cut-off value was 237.25 ng/mL,the sensitivity and specificity were 92.14%and 86.39%,respectively.Conclusion The IL-33 levels in serum and skin lesions of patients with CSCC is significantly increased.IL-33 can be used as a serological marker for the diagnosis of lymph node or distant metastasis of CSCC.