子宫内膜癌患者血清YKL-40、HSP70、iNOS的水平及意义

Levels and significance of serum YKL-40,HSP70 and iNOS in patients with endometrial cancer

目的分析子宫内膜癌(EC)患者血清甲壳质酶蛋白40(YKL-40)、热休克蛋白70(HSP70)、诱导型一氧化氮合酶(iNOS)的水平及意义。方法选取2021年4月至2023年4月华北理工大学附属医院收治的116例EC患者作为EC组,另选取同期在华北理工大学附属医院治疗的子宫内膜增生患者116例作为子宫内膜增生组,并将同期在华北理工大学附属医院进行体检的体检健康者116例作为对照组。比较各组血清YKL-40、HSP70、iNOS水平;比较不同临床特征EC患者血清YKL-40、HSP70、iNOS水平。采用受试者工作特征(ROC)曲线分析血清YKL-40、HSP70、iNOS水平对EC的诊断价值。采用多因素Logistic回归分析EC发生的影响因素。结果EC组患者血清YKL-40、HSP70、iNOS水平均高于对照组和子宫内膜增生组(P<0.05);对照组与子宫内膜增生组间血清YKL-40、HSP70、iNOS水平比较,差异均无统计学意义(P>0.05)。FIGO分期Ⅲ+Ⅳ期、淋巴结转移、深层浸润、低分化的EC患者血清YKL-40、HSP70、iNOS水平均高于FIGO分期Ⅰ+Ⅱ期、淋巴结未转移、浅层浸润、高分化的EC患者(P<0.05)。ROC曲线分析结果显示,YKL-40、HSP70、iNOS单独及3项联合检测诊断EC的AUC分别为0.810(95%CI:0.754~0.867)、0.810(95%CI:0.754~0.866)、0.826(95%CI:0.771~0.881)、0.913(95%CI:0.877~0.950),3项联合检测诊断EC的AUC大于YKL-40、HSP70、iNOS单项检测诊断EC的AUC(Z=2.971,P=0.003;Z=2.971,P=0.003;Z=2.571,P=0.010)。多因素Logistic回归分析结果显示,血清YKL-40、HSP70、iNOS水平升高均是EC发生的危险因素(P<0.05)。结论在EC患者中,血清YKL-40、HSP70、iNOS水平均明显升高,且与EC患者临床病理特征密切相关,有望成为筛查EC患者的血清标志物。

Objective To analyze the levels and significance of serum chitinase protein 40(YKL-40),heat shock protein 70(HSP70)and inducible nitric oxide synthase(iNOS)in the patients with endometrial cancer(EC).Methods A total of 116 patients with EC admitted and treated in the Affiliated Hospital of North China University of Science and Technology from April 2021 to April 2023 were selected as the EC group,and other 116 patients with endometrial hyperplasia treated at this hospital during the same period were selected as the endometrial hyperplasia group.A total of 116 healthy individuals undergoing physical examinations at this hospital during the same period were selected as the control group.The levels of serum YKL-40,HSP70 and iNOS were compared among the various groups group;the serum YKL-40,HSP70 and iNOS levels were compared among different clinical characteristics of EC patients.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum YKL-40,HSP70 and iNOS levels for EC.The multivariate logistic regression was adopted to analyze the influencing factors of EC occurrence.Results The levels of serum YKL-40,HSP70 and iNOS in the EC group were higher than those in the control group and endometrial hyperplasia group(P<0.05);there was no statistically significant difference in serum YKL-40,HSP70 and iNOS levels between the control group and endometrial hyperplasia group(P>0.05).The serum YKL-40,HSP70 and iNOS levels in the patients with FIGO stageⅢ+Ⅳ,lymph node metastasis,deep infiltration and low differentiation EC were higher than those in the patients with FIGO stageⅠ+Ⅱ,no lymph node metastasis,shallow infiltration and high differentiation EC(P<0.05).The ROC curve analysis results showed that the area under the curve(AUC)of YKL-40,HSP70 and iNOS alone and combined detection for diagnosing EC were 0.810(95%CI:0.754-0.867),0.810(95%CI:0.754-0.866),0.826(95%CI:0.771-0.881)and 0.913(95%CI:0.877-0.950)respectively.AUC of YKL-40,HSP70 and iNOS combination detection was greater than that of YKL-40,HSP70 and iNOS simple detection(Z=2.971,P=0.003;Z=2.971,P=0.003;Z=2.571,P=0.010).The results of multivariate Logistic regression analysis showed that increase of serum YKL-40,HSP70 and iNOS levels was the risk factor for the EC occurrence(P<0.05).Conclusion In EC patients,serum YKL-40,HSP70 and iNOS levels are significantly elevated and closely related to the clinicopathological characteristics of EC patients,which may be expected to become the serum biomarkers for screening EC patients.