CAJ | 학술논문

背景与目的：目前，检测鼻咽癌的病灶残留、复发、远处转移，评价放化疗敏感性及判断预后主要依赖影像学的检查。寻找鼻咽癌早期诊断及预后相关的特异性分子标志物对鼻咽癌的早期诊断及个体化治疗具有重要意义。本研究通过检测血清巨噬细胞炎性蛋白-3α(macrophage inflammatory protein-3α，MIP-3α)和cystatin A蛋白在鼻咽癌患者治疗前、后及健康人中的表达情况，探讨其在鼻咽癌诊断、与临床病理特征关系以及疗效评价中的作用。方法：应用定量酶联免疫吸附法检测140例初治无远处转移的鼻咽癌患者治疗前、治疗结束后血清中MIP-3α和cystatin A的表达情况，并以100名健康体检者为对照。结果：以血清MIP-3α水平为31 pg/mL及cystatin A水平为16 ng/mL诊断鼻咽癌的敏感度分别为92.1%及42.1%，特异度分别为86.0%及85.0%。140例鼻咽癌患者经过治疗后均达到完全缓解或者部分缓解。鼻咽癌患者治疗前血清MIP-3α和cystatin A水平显著高于治疗后和健康对照者。MIP-3α和cystatin A均与鼻咽癌临床分期相关，MIP-3α还与T分期有关。治疗后完全缓解患者的血清MIP-3α降至健康对照者水平。部分缓解患者仍高于健康对照者水平，而完全缓解与部分缓解患者的血清cystatin A均降至健康对照者水平。在1年内发生远处转移的患者治疗后血清MIP-3α和cystatin A水平均明显高于未发生远处转移患者和健康对照者。MIP-3α和cystatin A表达之间存在相关性。结论：血清MIP-3α水平作为辅助诊断鼻咽癌的指标有一定的临床意义。血清MIP-3α与cystatin A检测有助于判断鼻咽癌分期和治疗后的近期疗效。
배경여목적：목전，검측비인암적병조잔류、복발、원처전이，평개방화료민감성급판단예후주요의뢰영상학적검사。심조비인암조기진단급예후상관적특이성분자표지물대비인암적조기진단급개체화치료구유중요의의。본연구통과검측혈청거서세포염성단백-3α(macrophage inflammatory protein-3α，MIP-3α)화cystatin A단백재비인암환자치료전、후급건강인중적표체정황，탐토기재비인암진단、여림상병리특정관계이급료효평개중적작용。방법：응용정량매련면역흡부법검측140례초치무원처전이적비인암환자치료전、치료결속후혈청중MIP-3α화cystatin A적표체정황，병이100명건강체검자위대조。결과：이혈청MIP-3α수평위31 pg/mL급cystatin A수평위16 ng/mL진단비인암적민감도분별위92.1%급42.1%，특이도분별위86.0%급85.0%。140례비인암환자경과치료후균체도완전완해혹자부분완해。비인암환자치료전혈청MIP-3α화cystatin A수평현저고우치료후화건강대조자。MIP-3α화cystatin A균여비인암림상분기상관，MIP-3α환여T분기유관。치료후완전완해환자적혈청MIP-3α강지건강대조자수평。부분완해환자잉고우건강대조자수평，이완전완해여부분완해환자적혈청cystatin A균강지건강대조자수평。재1년내발생원처전이적환자치료후혈청MIP-3α화cystatin A수평균명현고우미발생원처전이환자화건강대조자。MIP-3α화cystatin A표체지간존재상관성。결론：혈청MIP-3α수평작위보조진단비인암적지표유일정적림상의의。혈청MIP-3α여cystatin A검측유조우판단비인암분기화치료후적근기료효。
Background and purpose:To date, it mainly depended on imaging examination for detection of residual lesions, recurrence and distant metastasis, evaluation the sensitivity of radiotherapy and chemotherapy, and prognosis in nasopharyngeal carcinoma (NPC). Thus, searching for new tumor markers for NPC early diagnosis and individualized treatment is still merited. This study was aimed to investigate the expressions of serum macrophage inflammatory protein (MIP)-3α and cystatin A in patients with NPC before and after treatment, and to explore two markers’ value in NPC diagnosis, clinicopathological characteristics and clinical outcome assessment. Methods:The serum levels of MIP-3αand cystatin A in 140 primary NPC patients without distant metastasis before and after treatment were detected by enzyme-linked immunosorbent assay (ELISA) and compared with those in 100 healthy controls. Results:The sensitivity of MIP-3αand cystatin A were 92.1%and 42.1%, respectively;and the specificity of MIP-3αand cystatin A were 86.0%and 85.0%, respectively. All 140 NPC patients had complete remission (CR) or partial remission (PR). Serum levels of MIP-3αand cystatin A in pre-treatment patients with NPC were higher than those in post-treatment patients and controls. Serum MIP-3αand cystatin A levels were associated with overall stage of NPC, and MIP-3αwas also associated with T classification of NPC. The serum MIP-3αlevel in NPC with CR after treatment reduced to the level in control group, and that was still significantly higher in NPC with PR than in control group. No significant difference was found in the serum cystatin A level between NPC with CR or PR after treatment and control group. During 1-year follow-up, the post-treatment serum levels of MIP-3αand cystatin A were significantly higher in patients with distant metastasis than in patients without distant metastasis and controls. There was found statistically significant correlation between MIP-3α and cystatin A.Conclusion:MIP-3α may be a potential marker of NPC serological diagnosis. The detection of serum MIP-3αand cystatin A may contribute to the NPC staging and prediction of short-term clinical outcomes.