IL-6和YKL-40在头颈部鳞状细胞癌患者预后评估中的价值

doi:10.3969/j.issn.1673-8640.2022.06.005

摘要/Abstract

摘要：

目的探讨白细胞介素（IL）-6和人类软骨糖蛋白39（YKL-40）在头颈部鳞状细胞癌（HNSCC）患者预后评估中的价值。方法选取HNSCC患者130例,检测其治疗前血清IL-6和YKL-40水平,同时收集相关临床资料。对所有患者进行随访,以全因死亡为随访终点。采用受试者工作特征（ROC）曲线确定IL-6和YKL-40判断HNSCC患者预后的最佳临界值。采用Kaplan-Meier曲线分析HNSCC患者的生存情况。采用Cox比例风险回归模型分析影响HNSCC患者总生存期的危险因素。结果 ROC曲线分析结果显示,IL-6和YKL-40判断HNSCC患者预后的最佳临界值分别为19.8 pg/mL和119 μg/L。与IL-6≤19.8 pg/mL组比较,IL-6>19.8 pg/mL组TNM分期Ⅲ期和Ⅳ期患者所占比例显著升高（P<0.05）;2个组之间性别、年龄、肿瘤部位和治疗方式差异均无统计学意义（P>0.05）。与YKL-40≤119 μg/L组比较,YKL-40>119 μg/L组年龄和TNM分期Ⅲ期、Ⅳ期患者所占比例显著升高（P<0.05）;2个组之间性别、肿瘤部位和治疗方式差异均无统计学意义（P>0.05）。IL-6>19.8 pg/mL组、YKL-40>119 μg/L组中位生存期分别显著短于IL-6≤19.8 pg/mL组和YKL-40≤119 μg/L组（P<0.001、P=0.002）。Cox比例风险回归分析结果显示,TNM分期、IL-6和YKL-40是影响HNSCC患者总生存期的危险因素[风险比（HR）值分别为2.65、1.78、1.69,95%可信区间（CI）分别为1.64~5.64、1.43~3.07、1.28~2.10]。结论 IL-6、YKL-40与HNSCC患者预后有关,二者联合检测或可用于评估患者预后。

关键词: 白细胞介素6, 人类软骨糖蛋白39, 头颈部鳞状细胞癌, 预后

Abstract:

Objective To investigate the prognostic roles of interleukin（IL）-6 and cartilage glycoprotein 39（YKL-40） for evaluating all-cause mortality in patients with head and neck squamous cell carcinoma（HNSCC）. Methods The data from 130 patients with HNSCC were analyzed. Serum IL-6 and YKL-40 were determined. All the patients were followed up,and the primary endpoint was all-cause mortality. Receiver operating characteristic （ROC） curve was used to determine the optimal cut-off values for the prognosis of HNSCC patients by IL-6 and YKL-40. Kaplan-Meier curve was used to analyze the survival of HNSCC patients. Cox proportional hazard model was used to determine risk factors for overall survival in patients with HNSCC. Results The optimal cut-off values of IL-6 and YKL-40 were 19.8 pg/mL and 119 μg/L. Compared with IL-6≤19.8 pg/mL,patients in IL-6>19.8 pg/mL had increased proportions of stage Ⅲ and Ⅳ in TNM classification（P<0.05）. There was no statistical significance for sex,age,tumor location and treatment method between the 2 groups （P>0.05）. Increased age and proportions of stage Ⅲ and Ⅳ were also noticed in YKL-40>119 μg/L group as compared with those in YKL-40≤119 μg/L group（P<0.05）. There was no statistical significance in sex,tumor location and treatment method between the 2 groups （P>0.05）. Survival analysis indicated that patients in IL-6>19.8 pg/mL group and YKL-40>119 μg/L group had reduced median survival time as compared with those in IL-6≤19.8 pg/mL group（P<0.001） and YKL-40≤119 μg/L group（P=0.002）. Cox regression analysis showed that TNM classification [hazard ratio（HR）=2.65,95% confidence interval（CI） 1.64-5.64],IL-6（HR=1.78,95%CI 1.43-3.07） and YKL-40（HR=1.69,95%CI 1.28-2.10）were risk factors for overall survival in patients with HNSCC. Conclusions IL-6 and YKL-40 are related to the prognosis of HNSCC patients,and the combined determination can be used in evaluating patients' prognosis.

Key words: Interleukin-6, Cartilage glycoprotein 39, Head and neck squamous cell carcinoma, Prognosis

中图分类号:

R446.1

王小飞, 傅江涛, 朱双媚. IL-6和YKL-40在头颈部鳞状细胞癌患者预后评估中的价值[J]. 检验医学, 2022, 37(6): 524-528.

WANG Xiaofei, FU Jiangtao, ZHU Shuangmei. Prognostic evaluation of IL-6 combined with YKL-40 in head and neck squamous cell carcinoma[J]. Laboratory Medicine, 2022, 37(6): 524-528.

图/表 4

参考文献 19

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指标	单因素分析		多因素分析
指标	HR值（95% CI）	P值	HR值（95% CI）	P值
年龄（≥60岁、<60岁）	1.28（0.99~1.32）	0.09	1.18（1.00~1.39）	0.08
性别（男、女）	1.01（0.91~1.32）	0.55	0.91（0.54~2.17）	0.71
肿瘤部位
口咽及其他部位	1.04（0.84~1.43）	0.43	1.02（0.87~1.33）	0.60
喉及其他部位	0.89（0.81~1.11）	0.61	0.92（0.56~1.54）	0.75
下咽及其他部位	1.24（0.92~1.59）	0.15	1.34（0.92~3.21）	0.10
TNM分期（Ⅲ~Ⅳ期、Ⅰ~Ⅱ期）	3.88（1.89~5.22）	<0.001	2.65（1.64~5.64）	<0.001
治疗方式（手术、非手术）	1.09（0.79~1.75）	0.58	0.95（0.49~1.86）	0.81
IL-6（>19.8 pg/mL、≤19.8 pg/mL）	3.35（2.03~5.53）	0.003	1.78（1.43~3.07）	0.008
YKL-40（>119 μg/L、≤119 μg/L）	2.10（1.33~3.30）	0.009	1.69（1.28~2.10）	0.02

指标	单因素分析		多因素分析
指标	HR值（95% CI）	P值	HR值（95% CI）	P值
年龄（≥60岁、<60岁）	1.28（0.99~1.32）	0.09	1.18（1.00~1.39）	0.08
性别（男、女）	1.01（0.91~1.32）	0.55	0.91（0.54~2.17）	0.71
肿瘤部位
口咽及其他部位	1.04（0.84~1.43）	0.43	1.02（0.87~1.33）	0.60
喉及其他部位	0.89（0.81~1.11）	0.61	0.92（0.56~1.54）	0.75
下咽及其他部位	1.24（0.92~1.59）	0.15	1.34（0.92~3.21）	0.10
TNM分期（Ⅲ~Ⅳ期、Ⅰ~Ⅱ期）	3.88（1.89~5.22）	<0.001	2.65（1.64~5.64）	<0.001
治疗方式（手术、非手术）	1.09（0.79~1.75）	0.58	0.95（0.49~1.86）	0.81
IL-6（>19.8 pg/mL、≤19.8 pg/mL）	3.35（2.03~5.53）	0.003	1.78（1.43~3.07）	0.008
YKL-40（>119 μg/L、≤119 μg/L）	2.10（1.33~3.30）	0.009	1.69（1.28~2.10）	0.02