血清MIC-1对术前评估非小细胞肺癌淋巴转移的价值-现代医学

血清MIC-1对术前评估非小细胞肺癌淋巴转移的价值

单位：1. 宜兴市人民医院心胸外科, 江苏宜兴 214200;
2. 宜兴市人民医院药学部, 江苏宜兴 214200

关键词：非小细胞肺癌淋巴转移巨噬细胞抑制因子-1 基质金属蛋白酶-9 细胞外基质

分类号：R734

出版年·卷·期（页码）：2025·53·第十一期（1726-1731）

摘要：

目的：探讨血清巨噬细胞抑制因子-1(MIC-1)对术前评估非小细胞肺癌(NSCLC)淋巴转移的价值。方法：选取2019年10月至2023年4月在宜兴市人民医院行肺癌根治术的60例NSCLC患者为研究对象，其中30例经术后病理明确有淋巴转移，30例无淋巴转移。采用ELISA方法检测手术当日清晨患者血清中MIC-1和基质金属蛋白酶-9(MMP-9)水平，Western blotting方法检测肿瘤组织MMP-9蛋白的表达水平。比较两组患者血清MIC-1和MMP-9及肿瘤组织MMP-9水平，采用Pearson相关分析研究血清MIC-1、MMP-9水平和肿瘤组织MMP-9水平的关系，用受试者工作特征(ROC)曲线分析血清MIC-1、MMP-9和肿瘤组织MMP-9水平以及MMP-9/ MIC-1 值用于术前评价NSCLC有无合并淋巴转移的诊断效能。结果： NSCLC合并淋巴转移组患者的血清MIC-1、MMP-9和肿瘤组织MMP-9水平均显著高于无淋巴转移组，差异有统计学意义(P＜0.05)。Pearson相关分析结果显示，NSCLC合并淋巴转移组患者血清MIC-1水平与肿瘤组织中MMP-9水平呈正相关(r=0.657，P＜0.05)，与血清中MMP-9水平不相关(r=0.081，P＞0.05)；而NSCLC无淋巴转移组患者的血清MIC-1、MMP-9水平和肿瘤组织MMP-9水平三者间均不相关(P＞0.05)。ROC曲线显示，血清MIC-1(最佳截断点＞1 271.60 pg·mL^-1)预测NSCLC合并淋巴转移的敏感度、特异度和准确度分别为66.7%、86.7%、76.7%，而肿瘤组织MMP-9和肿瘤组织MMP-9/血清MIC-1值判断NSCLC合并淋巴转移的最佳截断点分别为0.96和0.783，相应的敏感度、特异度和准确度分别为86.7%、83.3%、73.3%和86.7%、76.7%、81.7%。结论：血清MIC-1可作为术前评估NSCLC合并淋巴转移的辅助临床指标，它可能参与了MMP-9介导的细胞外基质降解机制。

Objective: To investigate the value of serum macrophage inhibitory cytokine-1(MIC-1) in preoperative evaluation of lymphatic metastasis of non-small cell lung cancer(NSCLC). Methods: A total of 60 NSCLC patients who underwent radical resection for lung cancer at Yixing People's Hospital between October 2019 and April 2023 were enrolled: 30 patients with lymphatic metastasis confirmed by postoperative pathology and 30 patients without lymphatic metastasis. On the morning of surgery, the levels of serum MIC-1 and matrix metallopeptidase 9(MMP-9) were detected by ELISA, and the level of intratumoral MMP-9 was determined by Western blotting. The levels of serum MIC-1, MMP-9 and intratumoral MMP-9 were compared between the two groups. The relationships of serum MIC-1 and MMP-9 levels and intratumoral MMP-9 level were analyzed using Pearson correlation analysis. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of serum MIC-1, serum MMP-9, intratumoral MMP-9, and the MMP-9/ MIC-1 ratio in distinguishing NSCLC with or without lymphatic metastasis preoperatively. Results: The levels of serum MIC-1, serum MMP-9 and intratumoral MMP-9 in NSCLC patients with lymphatic metastasis were significantly higher than those without lymphatic metastasis(P＜0.05). Pearson correlation analysis showed that in NSCLC patients with lymphatic metastasis, serum MIC-1 level was positively correlated with intratumoral MMP-9 level(r=0.657, P＜0.05), but was not correlated with serum MMP-9 level(r=0.081, P>0.05). However, among NSCLC patients without lymphatic metastasis, serum MIC-1, serum MMP-9 and intratumoral MMP-9 levels were not significantly correlated with each other(P>0.05). Using the optimal cut-off point of serum MIC-1＞1 271.60 pg·mL^-1, the sensitivity, specificity, and accuracy for predicting NSCLC with lymphatic metastasis were 66.7%, 86.7%, and 76.7%, respectively. For intratumoral MMP-9 and the MMP-9/serum MIC-1 ratio, the optimal cut-off points were 0.96 and 0.783, respectively, yielding sensitivities, specificities, and accuracies of 86.7%, 83.3%, 73.3% and 86.7%, 76.7%, 81.7%, respectively. Conclusion: Serum MIC-1 can be a promising auxiliary clinical index for preoperative evaluation of lymphatic metastasis in NSCLC, possibly through MMP-9-mediated extracellular matrix degradation.

参考文献：

[1] SUNG H,FERLAY J,SIEGEL R L,et al.Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2021,71(3):209-249.
[2] RECK M,HEIGENER D F,MOK T,et al.Management of non-small-cell lung cancer:recent developments[J].Lancet,2013,382(9893):709-719.
[3] IKEDA N.Updates on minimally invasive surgery in non-small cell lung cancer[J].Curr Treat Options Oncol,2019,20(2):16.
[4] ABBAS A E.Surgical management of lung cancer:history,evolution,and modern advances[J].Curr Oncol Rep,2018,20(12):98.
[5] 刘阳，张永臣，陈宝安，等.MIC-1和VEGF在非小细胞肺癌中的表达及与血管生成、预后的关系[J].现代医学，2021,49(8):817-822.
[6] LI Y,WANG X,Wang Y,et al.GDF15 as a potential biomarker for the diagnosis and prognosis of endometrial cancer[J].Cancer Med,2023,12(5):5897-5907.
[7] 王虹，赵伟，李敏，等.血清MIC-1、TK1水平与晚期非小细胞肺癌患者临床病理特征及预后的关系[J].现代医学，2022,50(3):285-290.
[8] LIU A,HOU F,QIN Y,et al.Predictive value of a prognostic model based on pathologic features in lung invasive adenocarcinoma[J].Lung Cancer,2019,131:14-22.
[9] DAI C,ZHANG X,MA Y,et al.Serum macrophage inhibitory cytokine-1 serves as a novel diagnostic biomarker of early-stage colorectal cancer[J].Biomarkers,2021,26(7):598-605.
[10] XU C,LI L,WANG W,et al.Serum macrophage inhibitory cytokine-1 as a clinical marker for non-small cell lung cancer[J].J Cell Mol Med,2021,25(6):3169-3172.
[11] YIN T,CHO S J,CHEN X.RNPC1,an RNA-binding protein and a p53 target,regulates macrophage inhibitory cytokine-1(MIC-1)expression through mRNA stability[J].J Biol Chem,2013,288(33):23680-23686.
[12] HAO L,ZHANG C,QIU Y,et al.Recombination of CXCR4,VEGF,and MMP-9 predicting lymph node metastasis in human breast cancer[J].Cancer Lett,2007,253(1):34-42.
[13] 吴国明，黄海雯，王慧，等.巨噬细胞抑制因子-1在肺癌骨转移患者血清中的表达及临床意义[J].现代医学，2020,48(5):553-557.

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