鳞状细胞癌抗原在慢性鼻窦炎伴鼻息肉患者血清中的表达及组织分型中的意义樊涛,姚汉兵,聂瑾,李湘胜 谢东海

Significance of squamous cell carcinoma antigen in patients with chronic rhinosinusitis with nasal polyps

摘要:

目的 探讨鳞状细胞癌抗原（squamous cell carcinoma antigen，SCCA）在慢性鼻窦炎伴鼻息肉（Chronic rhinosinusitis with nasal polyps，CRSwNP）患者血清中表达情况及其在组织分型中的应用价值。方法 选取74例CRSwNP患者以及40例健康志愿者作为研究对象，并根据术后组织病理切片中嗜酸性粒细胞浸润情况将CRSwNP分为非嗜酸性CRSwNP组（non-eCRSwNP，n=33）和嗜酸性CRSwNP组（eCRSwNP，n=41）。术前收集入组患者的外周血检测SCCA在血清中的浓度，并探讨其与临床指标的联系及其在不同组织分型患者中浓度差异。结果 与对照组相比，CRSwNP组患者血清SCCA表达水平显著升高（P＜0.0001）；与non-eCRSwNP组相比，eCRSwNP组患者血清SCCA表达水平显著升高（P＜0.0001）。CRSwNP患者血清SCCA浓度与外周血嗜酸性粒细胞计数（r=0.404，P=0.0004）、组织嗜酸性粒细胞比例（r=0. 283，P=0.015）均呈正相关。二元Logistic回归及ROC分析提示血清SCCA水平与CRSwNP组织 亚型具有明显的相关性并能较好地将两者进行区分（AUC=0.844，P=0.000）。结论CRSwNP 患者血清SCCA表达上调且与组织嗜酸性炎症相关，其表达水平可能有助于术前鉴别CRSwNP亚型。

Abstract:

Objective To investigate the expression of squamous cell carcinoma antigen (SCCA) on chronic rhinosinusitis with nasal polyps (CRSwNP) patients and its application value in the endotype of nasal polyps. Methods Seventy-four patients with CRSwNP and 40 healthy volunteers were enrolled in research. CRSwNP was divided into non-eCRSwNP group (n=33) and eCRSwNP(n=41) according to the tissue eosinophil ratio. The peripheral blood of the enrolled patients was collected before surgery to detect the serum concentration of SCCA, and we explored the correlation between SCCA and clinical indicators and the difference of SCCA concentration between patients with different endotype. Results Compared with the control group, the serum SCCA expression level in CRSwNP group was significantly increased (P < 0.0001). Compared with the non-eCRSwNP group, the serum SCCA expression level was significantly increased in the eCRSwNP group (P < 0.0001). Serum SCCA concentration in CRSwNP patients was positively correlated with eosinophil count in peripheral blood (r=0.404, P=0.0004) and tissue eosinophil ratio (r=0. 283, P=0.015). Binary logistic regression and ROC analysis indicated that the serum SCCA level was significantly correlated with CRSwNP tissue endotype (AUC=0.844, P=0.000). Conclusion Serum SCCA expression in CRSwNP patients is up-regulated and associated with tissue eosinophilic inflammation. The expression level of SCCA may be helpful for the preoperative identification of CRSwNP endotype.