血清补体成分7和载脂蛋白C-Ⅱ在局部进展期宫颈鳞状细胞癌放疗患者随访中的临床价值

Clinical value of serum complement component 7 and apolipoprotein C-Ⅱ in follow-up of patients with locally advanced cervical squamous cell carcinoma treated with radiotherapy

目的探讨血清补体成分7(C7)和载脂蛋白C-Ⅱ(ApoC-Ⅱ)在局部进展期宫颈鳞状细胞癌(CSCC)放疗患者随访中的临床价值。方法选取2018年5月至2020年1月沧州市人民医院收治的104例接受放疗或同步放化疗的局部进展期CSCC患者作为研究对象。采用酶联免疫吸附试验法检测血清C7和ApoC-Ⅱ水平,放疗完成1个月后进行随访,记录无病生存期(DFS)。采用受试者工作特征(ROC)曲线的曲线下面积(AUC)分析血清C7和APOC-Ⅱ水平对预后的预测价值;采用单因素和多因素Cox风险比例回归模型分析预后因素;采用Kaplan-Meier法绘制生存曲线并进行Log-Rank检验。结果血清C7和ApoC-Ⅱ联合检测的预测价值更高,AUC为0.938(95%CI:0.888~0.987)。血清C7与各临床病理特征均无显著相关性(P>0.05);高水平血清ApoC-Ⅱ与较大的肿瘤直径有关(P<0.05)。肿瘤直径、血清C7、ApoC-Ⅱ是影响局部进展期CSCC患者DFS预后的独立因素(P<0.05)。基于C7和ApoC-Ⅱ构建分子风险模型,该联合模型风险评分是CSCC患者DFS的独立预后因素(P<0.001)。Kaplan-Meier生存曲线显示,高风险和低/中风险患者DFS率分别为13.3%、89.2%,中位DFS时间分别为287、858 d(P<0.001)。结论血清C7和ApoC-Ⅱ水平降低与局部进展期CSCC患者预后较差显著相关,表明其是预测局部进展期CSCC患者放疗预后的潜在生物标志物。

Objective To investigate the clinical value of serum complement component 7(C7)and apolipoprotein C-Ⅱ(ApoC-Ⅱ)in the follow-up of patients with locally advanced cervical squamous cell carcinoma(CSCC)treated with radiotherapy.Methods A total of 104 patients with locally advanced CSCC who received radiotherapy or concurrent chemoradiotherapy in Cangzhou People′s Hospital from May 2018 to January 2020 were selected as the study objects.Serum C7 and ApoC-Ⅱlevels were detected by enzyme-linked immunosorbent assay(ELISA).Disease-free survival(DFS)was recorded after 1 month of follow-up after radiotherapy.The area under the curve(AUC)of receiver operating characteristic(ROC)curve was used to analyze the prognostic value of serum C7 and ApoC-Ⅱlevels.The prognostic factors were analyzed by univariate and multifactorial Cox proportional regression models.Kaplan-Meier method was used to draw the survival curve and Log-Rank test was performed.Results The predictive value of serum C7 and APC-Ⅱcombined detection was higher,with an AUC of 0.938(95%CI:0.888-0.987).There was no significant correlation between serum C7 and clinicopathological features(P>0.05).High levels of serum ApoC-Ⅱwere associated with larger tumor diameter(P<0.05).Tumor diameter,serum C7 and ApoC-Ⅱwere independent factors affecting the prognosis of DFS in patients with locally advanced CSCC(P<0.05).A molecular risk model was constructed based on C7 and ApoC-Ⅱ,and the combined model risk score was an independent prognostic factor for DFS in CSCC patients(P<0.001).Kaplan-Meier survival curves showed that the DFS rates of high-risk and low/medium risk patients were 13.3%and 89.2%,respectively,and the median DFS time was 287 days and 858 days,respectively(P<0.001).Conclusions Decreased levels of serum C7 and ApoC-Ⅱare significantly associated with poor prognosis in patients with locally advanced CSCC,suggesting that they are potential biomarkers for predicting radiotherapy prognosis in patients with locally advanced CSCC.