The Expression of Serum LCN2 and LTBP2 in Ovarian Cancer patients and Their Relationship with Clinicopathological Features and Prognosis
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摘要:
目的 探讨卵巢癌患者血清载脂运载蛋白-2(LCN2)、组织内转化生长因子β结合蛋白2(LTBP2)表达及其与临床病理特征和预后的关系。 方法 选择2020年2月至2021年12月在西安医学院附属宝鸡医院就诊的108例卵巢癌患者,纳入卵巢癌组,另选择同期108例卵巢良性病变患者纳入病变组,108例健康体检者纳入对照组。ELISA法检测血清LCN2、LTBP2表达水平;卵巢癌患者血清LCN2、LTBP2水平与预后生存率的关系采用Kaplan-Meier分析;影响卵巢癌患者预后的危险因素采用多因素Cox回归分析。 结果 对照组、病变组、卵巢癌组血清LCN2、LTBP2水平依次升高(P < 0.05);血清LCN2、LTBP2高表达患者FIGO III~IV期、肿瘤最大径>3 cm、术后淋巴结转移占比分别高于FIGO I~II期、肿瘤最大径≤3 cm、无淋巴结转移患者(P < 0.05);血清LCN2、LTBP2高表达卵巢癌患者中位生存时间分别低于血清LCN2、LTBP2低表达患者(Log-rank χ2=5.367、6.305,P < 0.05);FIGO III~IV期、肿瘤最大径>3 cm、术后淋巴结转移、LCN2、LTBP2高表达生存患者占比低于FIGO I~II期、肿瘤最大径≤3 cm、术后无淋巴结转移、LCN2、LTBP2低表达患者(P < 0.05);FIGO III~IV期、肿瘤最大径>3 cm、术后淋巴结转移、LCN2高表达、LTBP2高表达是影响患者3年生存率的独立危险因素(P < 0.05)。 结论 卵巢癌患者血清中LCN2、LTBP2表达上调,与术后淋巴结转移、FIGO分期、肿瘤最大径密切相关,是影响患者预后的重要因素,可能作为评估预后的生物标志物。 -
关键词:
- 卵巢癌 /
- 载脂运载蛋白-2 /
- 组织内转化生长因子β结合蛋白2 /
- 临床病理特征 /
- 预后
Abstract:Objective To explore the expression of serum lipocalin-2 (LCN2) and latent transforming growth factor-β binding protein 2 (LTBP2) in ovarian cancer patients and their relationship with clinicopathological features and prognosis. Methods A total of 108 ovarian cancer patients treated in Baoji Hospital Affiliated to Xi'an Medical College from February 2020 to December 2021 were included in the ovarian cancer group. Another 108 patients with benign ovarian lesions during the same period were included and labeled as the lesion group, and 108 healthy female volunteers undergoing physical examination were assigned to the control group. ELISA method was used to detect serum LCN2 and LTBP2 levels. The relationship between serum LCN2 and LTBP2 levels and prognosis survival rate in ovarian cancer patients was analyzed using the Kaplan-Meier method. Multivariate Cox regression analysis was performed to identify the risk factors affecting the prognosis of ovarian cancer patients. Results Serum LCN2 and LTBP2 levels increased in the control group, lesion group, and ovarian cancer group in sequence (P < 0.05). Among patients with high expression of serum LCN2 and LTBP2, the proportions of FIGO stage III-IV, tumor maximum diameter > 3 cm, and postoperative lymph node metastasis were higher than those of FIGO stages I-II, tumor maximum diameter ≤ 3 cm, and non lymph node metastasis (P < 0.05). The median survival time of ovarian cancer patients with high serum LCN2 and LTBP2 expression was lower than that of patients with low expression (Log-rank χ2=5.367、6.305, P < 0.05). The survival rate of patients with FIGO stage III~IV, maximum tumor diameter > 3 cm, postoperative lymph node metastasis, LCN2 and LTBP2 high expression was lower than that of patients with FIGO stage I~II, tumor maximum diameter ≤ 3 cm, no postoperative lymph node metastasis, and low LCN2 and LTBP2 expression (P < 0.05). FIGO stages III-IV, maximum tumor diameter > 3 cm, postoperative lymph node metastasis, high LCN2, and high LTBP2 were independent risk factors affecting the 3-year survival rate of ovarian cancer patients (P < 0.05). Conclusion Serum LCN2 and LTBP2 are upregulated in ovarian cancer patients, and are closely related to FIGO staging, tumor maximum diameter, and postoperative lymph node metastasis. They are important factors affecting prognosis and may serve as biomarkers for evaluating prognosis. -
表 1 卵巢癌组、病变组、对照组基线资料及血清LCN2、LTBP2水平比较[($ \bar x \pm s $)/n(%)]
Table 1. Baseline data and serum LCN2 and LTBP2 levels in the ovarian cancer group,lesion group and control group [($ \bar x \pm s $)/n(%)]
指标 类别 对照组(n=108) 病变组(n=108) 卵巢癌组(n=108) χ2/F P 年龄(岁) ≥50 47(43.52) 55(50.93) 51(47.22) 1.189 0.552 <50 61(56.48) 53(49.07) 57(52.78) BMI(kg/m2) 22.37 ± 2.41 22.84 ± 2.53 22.09 ± 2.38 2.604 0.076 绝经 是 42(38.89) 51(47.22) 48(44.44) 1.582 0.453 否 66(61.11) 57(52.78) 60(55.56) 生育史 有 89(82.41) 94(87.04) 100(92.59) 5.082 0.079 无 19(17.59) 14(12.96) 8(7.41) 肿瘤家族史 有 3(2.78) 5(4.63) 6(5.56) 0.467 0.792 无 105(97.22) 103(95.37) 102(94.44) LCN2(ng/mL) 2.97 ± 0.48 5.21 ± 1.02a 6.34 ± 1.25ab 336.419 <0.001* LTBP2(ng/mL) 1.79 ± 0.44 3.37 ± 0.65a 4.35 ± 1.14ab 282.174 <0.001* *P < 0.05;与对照组比较,aP < 0.05;与病变组比较,bP < 0.05。 表 2 血清LCN2、LTBP2水平与临床病理特征的关系[n(%)]
Table 2. Relationship between serum LCN2 and LTBP2 levels and clinicopathological features [n(%)]
指标 类别 n LCN2高表达(n=55) χ2 P LTBP2高表达(n=58) χ2 P 年龄(岁) ≥50 51 30(58.52) 2.412 0.120 27(52.94) 0.023 0.881 <50 57 25(43.86) 31(54.39) 绝经 是 48 29(60.42) 3.114 0.078 30(62.50) 2.689 0.101 否 60 26(43.33) 28(46.67) 病理类型 浆液性癌 75 39(52.00) 0.131 0.178 42(56.00) 1.256 0.262 黏液性癌 21 10(47.62) 9(42.86) 其他 12 6(50.00) 7(58.33) FIGO分期 I~II期 47 14(29.79) 14.878 <0.001* 19(40.43) 5.901 0.015* III~IV期 61 41(67.21) 39(63.93) 肿瘤最大径(cm) ≤3 62 25(40.32) 6.549 0.010* 27(43.55) 6.038 0.014* >3 46 30(65.22) 31(67.39) 腹水量(mL) ≥100 75 42(56.00) 2.529 0.112 44(58.67) 2.432 0.119 <100 33 13(39.39) 14(42.42) 分化程度 高分化 39 24(61.54) 2.606 0.106 21(53.85) 2.754 0.097 中分化 47 21(44.68) 22(46.81) 低分化 22 12(54.55) 15(68.18) 术后淋巴结转移 是 62 38(61.29) 6.257 0.012* 41(66.13) 9.039 0.003* 否 46 17(36.96) 17(36.96) 浸润程度 浸润 71 40(56.34) 2.429 0.119 39(54.93) 0.125 0.723 浅表 37 15(40.54) 19(51.35) *P < 0.05。 表 3 PC患者不同预后情况临床资料比较[n(%)]
Table 3. Comparison of clinical data among patients with PC with different prognoses [n(%)]
指标 类别 n 生存(n=86) 死亡(n=22) Log-rank χ2 P 年龄(岁) ≥50 51 44(86.27) 7(13.73) 2.504 0.217 <50 57 42(73.68) 15(26.32) 绝经 是 48 41(85.42) 7(14.58) 1.753 0.165 否 60 45(75.00) 15(25.00) 病理类型 浆液性癌 75 62(82.67) 13(17.33) 0.702 0.395 黏液性癌 21 15(71.43) 6(28.57) 其他 12 9(75.00) 3(25.00) FIGO分期 I~II期 47 42(48.84) 5(51.16) 4.719 0.019* III~IV期 61 44(22.73) 17(77.27) 肿瘤最大径(cm) ≤3 62 54(62.79) 8(37.21) 5.137 0.031* >3 46 32(36.36) 14(63.64) 腹水量(mL) ≥100 75 59(68.60) 16(31.40) 0.152 0.695 <100 33 27(72.73) 6(27.27) 分化程度 高分化 39 32(82.05) 7(17.95) 2.159 0.151 中分化 47 39(82.98) 8(17.02) 低分化 22 15(68.18) 7(31.82) 术后淋巴结转移 是 62 45(52.33) 17(47.67) 4.337 0.028* 否 46 41(77.27) 5(22.73) 浸润程度 浸润 71 53(61.63) 18(38.37) 3.216 0.084 浅表 37 33(81.82) 4(18.18) LCN2 低表达 53 47(88.68) 6(11.32) 5.198 0.024* 高表达 55 39(70.91) 16(29.09) LTBP2 低表达 50 45(90.00) 5(10.00) 6.249 0.009* 高表达 58 41(70.69) 17(29.31) *P < 0.05。 表 4 影响卵巢癌患者预后的因素分析
Table 4. Analysis of factors affecting the prognosis of ovarian cancer patients
影响因素 β SE Wald χ2 P HR 95%CI FIGO分期 1.140 0.458 6.196 0.013* 3.127 1.274~7.673 肿瘤最大径 0.786 0.322 5.608 0.018* 2.195 1.145~4.208 术后淋巴结转移 0.963 0.416 5.356 0.021* 2.619 1.159~5.919 LCN2 1.117 0.424 6.946 0.008* 3.057 1.332~7.018 LTBP2 0.992 0.403 6.061 0.014* 2.697 1.224~5.942 *P < 0.05。 -
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