鳞状细胞癌抗原在慢性鼻窦炎伴鼻息肉患者血清中的表达及组织分型中的意义

目的探讨鳞状细胞癌抗原(SCCA)在慢性鼻窦炎伴鼻息肉(CRSwNP)患者血清中的表达情况及其在组织分型中的应用价值。方法选取74例CRSwNP患者以及40例健康志愿者作为研究对象，根据CRSwNP患者术后组织病理切片中嗜酸性粒细胞浸润情况将CRSwNP分为非嗜酸性CRSwNP组(non-eCRSwNP，n=33)和嗜酸性CRSwNP组(eCRSwNP，n=41)。术前收集入组患者的外周血检测SCCA在血清中的浓度，观察其与临床指标的联系及其在不同组织分型患者中浓度差异。结果与对照组相比，CRSwNP组患者血清SCCA表达水平显著升高(P＜0.000 1)；与non-eCRSwNP组相比，eCRSwNP组患者血清SCCA表达水平显著升高(P＜0.000 1)。CRSwNP患者血清SCCA浓度与外周血嗜酸性粒细胞计数(r=0.404，P=0.000 4)、组织嗜酸性粒细胞比例(r=0.283，P=0.015)均呈正相关。二元Logistic回归及受试者工作曲线(ROC)分析提示血清SCCA水平与CRSwNP组织亚型具有明显的相关性并能较好地将两者进行区分[曲线下面积(AUC)=0.844，P=0.000]。结论CRSwNP患者血清SCCA表达上调且与组织嗜酸性炎症相关，其表达水平可能有助于术前鉴别CRSwNP亚型。

Significance and histological classification of the serum squamous cell carcinoma antigen level in chronic rhinosinusitis with nasal polyps patients

ObjectiveTo investigate the expression of squamous cell carcinoma antigen (SCCA) in patients of chronic rhinosinusitis with nasal polyps (CRSwNP) and its application value in different subtypes of nasal polyps.MethodsA total of 74 patients with CRSwNP and 40 healthy volunteers were selected as the research objects. CRSwNP patients were divided into non-eosinophilic CRSwNP group (non-ECRSWNP, n=33) and eosinophilic CRSwNP group (eCRSwNP, n=41) according to the eosinophilic infiltration in postoperative histopathological sections. The peripheral blood of the enrolled patients was collected before surgery to detect the serum concentration of SCCA, and to observe the correlation between SCCA and clinical indicators, which was analyzed for the difference of SCCA concentration between patients with different endotype.ResultsCompared with the control group, the serum SCCA expression level in CRSwNP group was significantly increased (P < 0.000 1). Compared with the non-eCRSwNP group, the serum SCCA expression level was significantly increased in the eCRSwNP group (P < 0.000 1). Serum SCCA concentration in CRSwNP patients was positively correlated with eosinophil count in peripheral blood (r=0.404, P=0.000 4) and tissue eosinophil ratio (r=0.283, P=0.015). Binary logistic regression and ROC analysis indicated that the serum SCCA level was significantly correlated with CRSwNP tissue endotype (AUC=0.844, P=0.000).ConclusionSerum SCCA expression in CRSwNP patients is up-regulated and associated with tissue eosinophilic inflammation. The expression level of SCCA may be helpful for the preoperative identification of CRSwNP endotype.