组织蛋白酶B在鼻咽癌患者组织和血清中的表达及临床意义

Expression of cathepsin B and its clinical significance in tissues and serum of nasopharyngeal carcinoma

摘要:

目的 通过测定组织蛋白酶B （Capthesin B）在鼻咽癌组织和血清标本中的表达量，探讨Capthesin B作为评估鼻咽癌患者治疗预后的可行性。方法 收集长沙金域医学检验中心2019年8月—2020年2月50例鼻咽癌组织和癌旁正常组织标本，免疫组织化学（IHC）检测组织标本Capthesin B表达，比较分析蛋白表达差异。收集湖南省肿瘤医院2019年7月—2020年3月106例鼻咽癌患者治疗前、治疗后及40例健康体检者的血清标本，ELISA试验检测血清Capthesin B浓度，并比较分析3组间的血清Capthesin B浓度。结果 IHC结果显示，鼻咽癌组织Capthesin B阳性率显著高于癌旁正常组织（P< 0.001）。ELISA结果表明，鼻咽癌患者血清Capthesin B 1.23（0.64，2.27） ng/mL显著高于健康体检组的（0.98 ±0.49） ng/mL （P< 0.05），鼻咽癌患者治疗后血清Capthesin B 0.69（0.39，1.42） ng/mL显著低于治疗前的1.23（0.64，2.27） ng/mL （P<0.001）。TNM分期III、IV患者血清Capthesin B （2.09 ±1.50） ng/mL显著高于I、II期患者的1.14（0.60，2.12） ng/mL，提示Capthesin B水平与TNM分期显著相关（P<0.05）。鼻咽癌颈淋巴结转移组血清Capthesin B （2.63±1.67） ng/mL显著高于未转移组的1.10（0.59，2.14） ng/mL （P<0.01），提示Capthesin B与转移相关。工作特征（ROC）曲线下面积（AUC）为0.670（P<0.001），提示血清Capthesin B可作为鼻咽癌疗效预测的参考指标。结论 鼻咽癌组织Capthesin B高表达和患者血清Capthesin B浓度明显升高，治疗后其浓度降低，提示Capthesin B与鼻咽癌发生发展密切相关。Capthesin B与肿瘤淋巴结转移及TNM分期呈正相关，提示Capthesin B可作为鼻咽癌治疗预后的参考指标。

关键词:鼻咽癌;组织蛋白酶 B;生物标志物;预后

Abstract:

Objective The study investigates the feasibility of Capthesin B as a marker for evaluating the therapeutic efficiency of nasopharyngeal carcinoma (NPC) patients through detecting the expression of Capthesin B in NPC tissues and serum. Methods The tumor and adjacent normal tissue samples from 50 NPC patients were obtained through biopsy. Immunohistochemistry (IHC) was used to detect the expression of Capthesin B in the tissues of these samples, which were collected in Changsha Jinyu Medical Laboratory Center from August 2019 to February 2020. Serum samples from 40 healthy subjects and from 106 patients with NPC before and after treatment were collected in Hunan Cancer Hospital from July 2019 to March 2020. Capthesin B in the serum was detected by ELISA, and the serum concentrations of Capthesin B among the three groups were compared and analyzed. Results IHC results showed that the positive rate of Capthesin B in NPC tissues was significantly higher than that in adjacent tissues (P<0.01). ELISA data showed that the serum level of Capthesin B in nasopharyngeal carcinoma patients 1.23 (0.64, 2.27) ng/mL was significantly higher than that in healthy subjects (0.98 ±0.49) ng/mL (P<0.01). The serum Capthesin B of NPC patients after treatment 0.69 (0.39, 1.42) ng/mL was significantly lower than that before treatment 1.23 (0.64, 2.27) ng/mL (P<0.001). The area under the ROC curve (AUC) was 0.670 (P<0.05), which suggested that Capthesin B may be used as a reference for predicting the therapeutic efficiency of NPC. The serum Capthesin B of TNM stage III、IV NPC patients (2.09 ±1.50) ng/mL was significantly higher than that of TNM stage I、II NPC patients 1.14 (0.60, 2.12) ng/mL, which indicated that Capthesin B was significantly correlated with TNM stage (P<0.05). Serum Capthesin B in the metastatic group (2.63 ±1.67) ng/mL was remarkably higher than that in the non-metastatic group 1.10 (0.59,2.14) ng/mL (P<0.01), which suggested that serum Capthesin B may be used as a biomarker for predicting NPC metastasis. Conclusion The level of Capthesin B expression in NPC tissues and in NPC serum were significantly increased, but decreased after treatment of NPC, which suggested that Capthesin B is closely related to NPC development. Capthesin B was positively correlated with lymph node metastasis and TNM stage, which suggested that Capthesin B could be used as a biomarker for evaluating NPC prognosis.

Key words:Nasopharyngeal carcinoma;Capthesin B;Biomarker;Prognosis