检验医学 ›› 2026, Vol. 41 ›› Issue (5): 413-423.DOI: 10.3969/j.issn.1673-8640.2026.05.001

• 论著 •    下一篇

肿瘤微环境中胶原小肽在肺腺癌诊断中的临床价值

程亚玲1, 叶敬文2, 刘家辉2, 杜凤麟1, 黄昕2, 钱文莉2, 董明星3, 娄加陶2()   

  1. 1.蚌埠医科大学生命科学学院,安徽 蚌埠 233030
    2.上海交通大学医学院附属第一人民医院检验医学中心,上海 200080
    3.上海交通大学医学院附属胸科医院检验科,上海 200030
  • 收稿日期:2025-10-11 修回日期:2026-04-07 出版日期:2026-05-30 发布日期:2026-05-29
  • 通讯作者: 娄加陶,E-mail:loujiatao@sjtu.edu.cn。
  • 作者简介:程亚玲,女,2001年生,硕士,主要从事肺癌骨转移相关机制研究。
  • 基金资助:
    国家自然科学基金面上项目(82273380);上海市青年科技启明星计划资助项目(23QA1407900);上海市科学技术委员会探索者计划资助项目(25TS1411100)

Clinical value of collagen oligopeptides in the tumor microenvironment for the diagnosis of lung adenocarcinoma

CHENG Yaling1, YE Jingwen2, LIU Jiahui2, DU Fenglin1, HUANG Xin2, QIAN Wenli2, DONG Mingxing3, LOU Jiatao2()   

  1. 1. Bengbu Medical University School of Life Science,Bengbu 233030,Anhui,China
    2. Clinical Laboratory Medicine Center,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China
    3. Department of Clinical Laboratory,Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China
  • Received:2025-10-11 Revised:2026-04-07 Online:2026-05-30 Published:2026-05-29

摘要:

目的 探讨肿瘤微环境中胶原小肽(COP)在肺腺癌诊断中的价值。方法 选取2011年3月23日—2019年3月22日上海交通大学医学院附属胸科医院肺腺癌患者47例,收集癌组织和配对的癌旁组织。采用广泛靶向代谢组技术分析癌组织和癌旁组织的代谢物谱,确定小肽的代谢差异。采用C57BL/6J小鼠构建动物模型(肺原位成瘤),分析小鼠肺癌组织和正常肺组织之间小肽的代谢差异,比较总胶原蛋白和组织蛋白酶(CTS)L表达的差异。将A549细胞分别转染小干扰RNA(siRNA)阴性对照(NC-siRNA)、CTSL-siRNA1、CTSL-siRNA2和CTSL-siRNA3,分析细胞培养上清液中小肽的代谢变化。采用Pearson相关分析评估氨基酸小肽与胶原蛋白的相关性,采用受试者工作特征(ROC)曲线评价氨基酸小肽单项检测和联合检测诊断肺腺癌的效能。结果 检出256个癌组织和癌旁组织的差异代谢物;氨基酸及其代谢物中有25种小肽代谢异常富集,富集程度最高的3种小肽分别为甘氨酰-异亮氨酸(Ile)、L-天冬氨酰(Asp)-L-苯丙氨酸(Phe)、L-亮氨酰(Leu)-甘氨酸(Gly)。肺腺癌患者癌组织和癌旁组织差异性代谢物中的Gly小肽分别为Gly-Ile、Leu-Gly、Gly-色氨酸(Trp)、Gly-酪氨酸(Tyr)、Gly-Gly-Phe,诊断肺腺癌的曲线下面积(AUC)分别为0.932、0.947、0.873、0.849、0.901;基于3种机器学习算法[随机森林(RF)、支持向量机(SVM)、逻辑回归(LR)]得出的这5种差异性Gly小肽联合检测诊断肺腺癌的AUC分别为1.000、0.944、0.944。与小鼠正常肺组织比较,小鼠肺癌组织中谷氨酸小肽L-苏氨酸-L-谷氨酸(Thr-Glu)、胶原蛋白、CTSL表达均显著升高(P<0.05)。Thr-Glu水平与胶原蛋白表达呈显著正相关(r=0.824,P<0.05)。基于TCGA数据库的分析结果显示,与正常癌旁组织比较,肺腺癌组织中COL1A1、COL1A2、COL2A1、COL3A1和CTSL均呈高表达(P<0.05)。与正常肺支气管上皮细胞BEAS-2B比较,人源肺癌细胞系H460、A549、H1437中CTSL mRNA和蛋白均呈高表达。与NC-siRNA组比较,CTSL-siRNA1组、CTSL-siRNA2组和CTSL-siRNA3组CTSL mRNA和蛋白表达均显著下降(P<0.001);CTSL-siRNA3组细胞培养上清液中COP(Gly-Glu)水平显著下降(P<0.01)。结论 肺腺癌患者肿瘤微环境中COP代谢升高,或可作为诊断肺腺癌的生物学指标。

关键词: 胶原小肽, 肺腺癌, 胶原蛋白, 组织蛋白酶L

Abstract:

Objective To investigate the value of collagen oligopeptides(COP)in the tumor microenvironment in the diagnosis of lung adenocarcinoma. Methods A total of 47 patients with lung adenocarcinoma from Shanghai Chest Hospital of Shanghai Jiao Tong University School of Medicine from March 23,2011 to March 22,2019 were enrolled,and cancer tissues and paired adjacent tissues were collected. The metabolite profiles of cancer tissues and adjacent tissues were analyzed using broad-targeted metabolomics technology to determine the metabolic differences of oligopeptides. An animal model of lung adenocarcinoma was established in C57BL/6J mice(in situ lung tumor formation),and the metabolic differences of oligopeptides between lung cancer tissues and normal lung tissues in mice were analyzed,and the differences in total collagen and cathepsin(CTS)L expression were compared. A549 cells were transfected with negative control small interfering RNA(siRNA)(NC-siRNA),CTSL-siRNA1,CTSL-siRNA2 and CTSL-siRNA3,respectively,and the metabolic changes of oligopeptides in the cell culture supernatant were determined. Pearson correlation analysis was used to evaluate the correlation between amino acid oligopeptides and collagen,and receiver operating characteristic(ROC)curve was used to evaluate the efficacy of single and combined determination of amino acid oligopeptides in the diagnosis of lung adenocarcinoma. Results A total of 256 differential metabolites from cancer and adjacent tissues were identified. Among the amino acids and their metabolites,25 oligopeptides were abnormally enriched,with the top 3 most enriched oligopeptides being L-glycyl-isoleucine(Ile),L-aspartyl (Asp)-L-phenylalanine(Phe),L-leucylglycine(Leu)-glycine(Gly). The diagnostic areas under curves(AUC)of all Gly oligopeptides in cancer tissues and adjacent tissues of lung adenocarcinoma patients were 0.932,0.947,0.873,0.849 and 0.901 for Gly-Ile,Leu-Gly,Gly-tryptophan(Trp),Gly-tyrosine(Tyr) and Gly-Gly-Phe,respectively. The combined determination of these 5 differentially expressed Gly oligopeptides based on 3 machine learning algorithms [random forest(RF),support vector machine(SVM)and logistic regression(LR)] had AUC of 1.000,0.944 and 0.944,respectively,for the diagnosis of lung adenocarcinoma. Compared with normal mouse lung tissues,the levels of L-threonyl(Thr)-glutamic acid(Glu),collagen and CTSL in mouse lung cancer tissues were increased(P<0.05). The level of Thr-Glu was positively correlated with collagen expression(r=0.824,P<0.05). The analysis based on the Cancer Genome Atlas Program(TCGA)database showed that COL1A1,COL1A2,COL2A1,COL3A1 and CTSL were highly expressed in lung adenocarcinoma tissues compared with normal adjacent tissues(P<0.05). Compared with normal human bronchial epithelial cells BEAS-2B,the CTSL mRNA and protein were highly expressed in human lung cancer cell lines H460,A549 and H1437. Compared with the NC-siRNA group,the expression of CTSL mRNA and protein in the CTSL-siRNA1 group,CTSL-siRNA2 group and CTSL-siRNA3 group was decreased(P<0.001). The level of COP(Gly-Glu)in the cell culture supernatant of CTSL-siRNA3 group was decreased(P<0.01). Conclusions The metabolism of COP in the tumor microenvironment of lung adenocarcinoma patients is elevated,which may serve as a biological indicator for the diagnosis of lung adenocarcinoma.

Key words: Collagen oligopeptide, Lung adenocarcinoma, Collagen, Cathepsin L

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