摘要
目的评估循环肿瘤细胞(circulating tumor cells,CTC)、miR-100联合鳞状细胞癌抗原(squamous cell carcinoma antigen,SCC-Ag)检测对局部晚期宫颈癌(locally advanced cervical cancer,LACC)放疗患者预后的影响。方法选择2017-01/2022-04月作者医院145例接受放疗或同步放化疗(concurrent chemoradiotherapy,CCRT)的LACC患者为研究对象。检测初次就诊时CTC、miR-100水平与临床病理参数之间的关系。使用Cox比例风险回归模型进行单变量和多变量生存分析。随访主要终点为无进展生存期(progression-free survival,PFS),次要终点包括总生存期(overall survival,OS)、骨盆PFS(pelvic progression-free survival,PPFS)和远处无转移生存期(distant metastasis-free survival,DMFS)。结果145例LACC患者CTC的阳性率为55.86%(81/145),即CTC≥3 CTC/3.2 ml。放疗前miR-100水平为0.23(0.18,0.29)。miR-100<0.23的患者国际妇产科联盟(international federation of obstetrics and gynecology,FIGO)Ⅲ~ⅣA期比例更高(P=0.004),CTC≥3 CTC/3.2 ml的LACC患者的肿瘤直径更大(P=0.032)。42例(28.97%)患者获得疾病进展。受试者工作特征(receiver operating characteristic,ROC)曲线分析显示,SCC-Ag、CTC和miR-100预测LACC进展的最佳截断值为4.35 ng/ml、4.50 CTC/3.2 ml和0.23,三者联合预测疾病进展的灵敏度和特异度分别为73.80%和75.70%。SCC-Ag水平升高、CTC增加、miR-100水平降低与LACC患者PFS、OS、PPFS、DMFS较差有关(P<0.05)。多变量分析表明,SCC-Ag、CTC、miR-100是PFS的独立危险因素(P<0.05)。结论SCC-Ag、CTC和miR-100是预测LACC患者预后的潜在生物标志物,三者联合检测可显著提高LACC患者生存预测能力。
Objective To evaluate the effects of circulating tumor cells(CTC)and miR-100 combined squamous cell carcinoma antigen(SCC-Ag)detection on the prognosis of patients with locally advanced cervical cancer(LACC)treated with radiotherapy.Methods A total of 145 patients with LACC received radiotherapy or concurrent chemoradiotherapy(CCRT)were selected from January 2017 to April 2022.The relationship between CTC,miR-100 level and clinicopathologic parameters at first visit was detected.Univariate and multivariate survival analysis were performed by Cox proportional hazard regression models.The primary endpoint of follow-up was progression-free survival(PFS),and secondary endpoints included overall survival(OS),pelvic progression-free survival(PPFS)and distant metastasis-free survival(DMFS).Results The positive rate of CTC in 145 LACC patients was 55.86%(81/145),that is,CTC≥3 CTC/3.2 ml.The miR-100 level before radiotherapy was 0.23(0.18,0.29).Patients with miR-100<0.23 had a higher proportion of international federation of obstetrics and gynecology(FIGO) Ⅲ to Ⅳ at A stage(P=0.004),the tumor diameter was larger in LACC patients with CTC≥3 CTC/3.2 ml(P=0.032).Forty-two patients(28.97%)achieved disease progression in this study.The best cut-off values for SCC-Ag,CTC and miR-100 predicting LACC progression were 4.35 ng/ml,4.50 CTC/3.2 ml and 0.23 respectively according to the analysis of receiver operating characteristic(ROC)curve.The sensitivity and specificity for predicting disease progression were 73.80% and 75.70% respectively.Increasing SCC-Ag level,increasing CTC and decreasing miR-100 level were associated with poor PFS,OS,PPFS and DMFS in LACC patients(P<0.05).Multivariate progression showed that SCC-Ag,CTC and miR-100 were independent risk factors for PFS(P<0.05).Conclusion SCC-Ag,CTC and miR-100 are potentially biomarkers for predicting the prognosis of LACC patients,and the joint detection of the three can significantly improve the ability to predict the survival of LACC patients.
作者
谢程
夏思
李红霞
XIE Cheng;XIA Si;LI Hongxia(Department of Gynaecology and Obstetrics,Xiantao First People’s Hospital Affiliated to Changjiang University,Xiantao Hubei 433000,China)
出处
《联勤军事医学》
CAS
2023年第10期837-843,共7页
Military Medicine of Joint Logistics
基金
湖北省卫生健康委科研项目(WJ2021-05)。
关键词
循环肿瘤细胞
miR-100
鳞状细胞癌抗原
局部晚期宫颈癌
放疗
生存预后
Circulating tumor cells
miR-100
Squamous cell carcinoma antigen
Locally advanced cervical cancer Radiotherapy
Survival prognosis