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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。
BACKGROUND & OBJECTIVE: Currently, the detection of residual, recurrence and distant metastasis of nasopharyngeal carcinoma, the evaluation of chemoradiation sensitivity and prognosis mainly depend on the imaging examination. Looking for early diagnosis of nasopharyngeal carcinoma and prognosis related molecular markers specific for the early diagnosis of nasopharyngeal carcinoma and individualized treatment is of great significance. In this study, we examined the expression of macrophage inflammatory protein-3α (MIP-3α) and cystatin A protein in patients with nasopharyngeal carcinoma (NPC) before and after treatment, Cancer diagnosis, the relationship with clinicopathological features and the role of efficacy evaluation. Methods: The expression of MIP-3α and cystatin A in serum of 140 newly diagnosed nasopharyngeal carcinoma patients without distant metastasis before and after treatment were detected by quantitative enzyme-linked immunosorbent assay (ELISA), and compared with 100 healthy subjects . Results: The sensitivity of nasopharyngeal carcinoma with serum MIP-3α level of 31 pg / mL and cystatin A level of 16 ng / mL was 92.1% and 42.1%, respectively, with a specificity of 86.0% and 85.0%, respectively. 140 cases of nasopharyngeal carcinoma patients after treatment were completely relieved or partially relieved. The levels of serum MIP-3α and cystatin A in patients with nasopharyngeal carcinoma before treatment were significantly higher than those in healthy controls. Both MIP-3α and cystatin A are associated with the clinical stage of NPC and MIP-3α with T stage. After treatment, patients with complete remission serum MIP-3α decreased to the level of healthy controls. Partial remission patients were still higher than the level of healthy controls, and complete remission and partial remission of serum cystatin A were reduced to the level of healthy controls. The levels of serum MIP-3α and cystatin A in patients with distant metastasis within one year after treatment were significantly higher than those without distant metastasis and healthy controls. There was a correlation between MIP-3α and cystatin A expression. Conclusion: Serum MIP-3α level as a diagnostic index for nasopharyngeal carcinoma has some clinical significance. Serum MIP-3α and cystatin A test can help determine the nasopharyngeal carcinoma staging and treatment of the short-term effect.