血清Lipocalin-2和YKL-40联合检测对食管癌患者新辅助放化疗效果的预测价值

doi:10.3969/j.issn.1004-616x.2025.04.014

摘要/Abstract

摘要： 目的：探讨脂质运载蛋白(Lipocalin-2)、壳多糖酶3样蛋白1(YKL-40)在食管癌(EC)患者血清中的含量，及其联合检测对预测EC患者新辅助放化疗效果的价值。方法：收集2021年1月—2022年8月在华北医疗健康集团邯矿总医院进行新辅助放化疗的200例EC患者作为研究对象，根据患者治疗5周期的疗效情况分为有效组(128例)和无效组(72例)。比较两组患者治疗前血清Lipocalin-2、YKL-40、癌胚抗原(CEA)浓度；logistic回归分析EC患者新辅助放化疗效果的影响因素；采用受试者工作特征(ROC)曲线分析血清Lipocalin-2、YKL-40、CEA对EC患者新辅助放化疗效果的预测价值。结果：与有效组相比，无效组患者血清Lipocalin-2、YKL-40、CEA含量均显著升高(P<0.05)；血清Lipocalin-2、YKL-40、CEA为EC患者新辅助放化疗效果的影响因素(P<0.05)。ROC曲线显示血清Lipocalin-2、YKL-40、CEA三者联合预测EC患者新辅助放化疗效果的AUC为0.975，敏感性为95.65%，特异性为89.29%，优于三者各自单独预测(Z_{联合-Lipocalin-2}=23.868，P<0.01；Z_{联合-YKL-40}=3.918，P<0.01；Z_联合-CEA=3.742，P<0.01)。结论： EC新辅助放化疗治疗无效患者血清Lipocalin-2、YKL-40浓度较高，两者与传统肿瘤标志物CEA联合对预测EC新辅助放化疗效果有较好的参考价值。

关键词: 脂质运载蛋白, 壳多糖酶3样蛋白1, 食管癌, 新辅助放化疗, 疗效

Abstract: OBJECTIVE： To investigate the levels of Lipocalin-2 and YKL-40 in serum samples from esophageal cancer (EC) patients and their relationship with therapeutic effect of neoadjuvant radiotherapy and chemotherapy. METHODS： From January 2021 to August 2022，a total of 200 EC patients who underwent neoadjuvant radiotherapy and chemotherapy in the Hankuang General Hospital of North China Medical and Health Group were recruited as research subjects. All patients were examined 5 cycles after treatment，according to the therapeutic effect of patients. They were grouped into effective (128 cases) and ineffective groups (72 cases). The contents of serum Lipocalin-2，YKL-40 and carcinoembryonic antigen (CEA) were compared between the two groups before treatment；logistic regression was applied to analyze the influencing factors of neoadjuvant radiotherapy and chemotherapy therapeutic effect in EC patients. Receiver operating characteristic (ROC) was applied to analyze the predictive value of serum Lipocalin-2，YKL-40 and CEA in the therapeutic effect among the patients. RESULTS： Compared with the effective group，the contents of serum Lipocalin-2，YKL-40，and CEA in the ineffective group were significantly increased (P<0.05). Serum Lipocalin-2，YKL-40，and CEA were the factors for the therapeutic effect of the two therapies (P<0.05). ROC curve showed that the AUC of combined serum Lipocalin-2，YKL-40 and CEA predicted the efficacy of the therapy at 0.975，with sensitivity of 95.65%，and specificity of 89.29%. It was better than the three individual predictions (Z_{combination-Lipocalin-2}=23.868，P<0.01；Z_{combination-YKL-40}=3.918，P<0.01；Z_{combination-CEA}=3.742，P<0.01). CONCLUSION： Serum Lipocalin-2 and YKL-40 contents were significantly increased in patients who did not respond to EC neoadjuvant chemoradiotherapy，and the combination of Lipocalin-2 and YKL-40 with the traditional tumor marker CEA has good reference value in predicting the therapeutic effect of neoadjuvant radiotherapy and chemotherapy for EC.

Key words: lipocalin, chitosanase 3-like protein 1, esophageal cancer, neoadjuvant radiotherapy and chemotherapy, therapeutic effect

中图分类号:

R735.1

杨智慧, 韩翔龙, 刘艮钢, 石捷. 血清Lipocalin-2和YKL-40联合检测对食管癌患者新辅助放化疗效果的预测价值[J]. 癌变·畸变·突变, 2025, 37(4): 310-313,318.

YANG Zhihui, HAN Xianglong, LIU Gengang, SHI Jie. Relationships between serum Lipocalin-2 and YKL-40 levels on therapeutic effect of neoadjuvant radiotherapy and chemotherapy in esophageal cancer patients[J]. Carcinogenesis, Teratogenesis & Mutagenesis, 2025, 37(4): 310-313,318.

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