Syndecan-1蛋白在皮肤鳞状细胞癌的表达及意义

目的 检测皮肤鳞状细胞癌（鳞癌）患者血清可溶性多配体蛋白聚糖1（SDC1）水平和SDC1蛋白在组织中的表达及两者的相关性。 方法 免疫组化方法检测93例鳞癌及30例健康对照者表皮SDC1的表达，酶联免疫吸附测定（ELISA）检测81例鳞癌患者和30例健康对照者血清中可溶性SDC1的表达水平。 结果 鳞癌组织中，SDC1表达明显低于健康对照组（Z = 3.85，P < 0.01）。在不同肿瘤厚度和分化程度的鳞癌中，SDC1表达强度随肿瘤厚度的增加和分化程度地降低而有下降趋势（χ2分别为11.66和12.51，均P < 0.01）。鳞癌患者中伴淋巴结转移组SDC1表达强度显著低于无淋巴结转移组（Z = 2.20，P < 0.05）。鳞癌患者血清可溶性SDC1表达水平显著高于健康对照组（Z = 4.12，P < 0.01），且随着肿瘤厚度的增加和临床分期的变晚血清可溶性SDC1水平逐渐升高。侵袭性鳞癌的SDC1水平高于原位鳞癌的患者（Z = 3.02，P < 0.01），但不同分化程度的侵袭性鳞癌血清SDC1水平比较，差异无统计学意义（均P > 0.05）。有淋巴结转移的鳞癌患者血清SDC1水平明显高于无淋巴结转移组（Z = 5.30，P < 0.01）。鳞癌患者血清中可溶性SDC1的水平与组织中SDC1表达强度呈负相关（rs = -0.625，P < 0.01）。用受试者工作曲线法判断血清可溶性SDC1水平对诊断有无淋巴结转移的最佳临界点为65.5 μg/L，其敏感度为73.7%，特异度为87.1%，曲线下面积值为0.904（0.840 ~ 0.968）。 结论 鳞癌组织中，SDC1表达减弱和血清中可溶性SDC1水平升高与鳞癌的侵袭性相关，血清SDC1水平升高对鳞癌患者淋巴结转移的诊断具有一定的价值。

Syndecan-1 expression in cutaneous squamous cell carcinoma and its significance

Objective To measure serum and tissue levels of soluble syndecan-1 (SDC1) in patients with cutaneous squamous cell carcinoma (CSCC),and to explore the relationship between the expression of SDC1 and clinicopathologic features of CSCC as well as between the serum and tissue levels of SDC 1.Methods An immunohistochemical study was performed to measure SDC 1 expression in the epidermis of lesional specimens from 93 patients with CSCC and normal skin specimens from 30 healthy human controls,and enzyme-linked immunosorbent assay (ELISA) to detect serum levels of soluble SDC1 in 81 patients with CSCC and 30 healthy human controls.Results The expression of SDC1 was significantly lower in CSCC tissues than in normal skin tissues (Z=3.85,P＜ 0.01).The expression intensity of SDC 1 decreased with the increase in tumor thickness but with the decrease in degree of differentiation of CSCC (x2 =11.66,12.51 respectively,both P ＜ 0.01).Furthermore,the expression of SDC1 was significantly lower in lesional tissues of CSCC with lymph node metastasis than in those without (Z =2.20,P ＜ 0.05).As ELISA showed,serum levels of soluble SDC1 were significantly higher in patients with CSCC than in healthy controls (Z=4.12,P＜ 0.01),and gradually increased with the increase in tumor thickness and with advancing clinical stages of CSCC.In addition,serum levels of SDC1 were significantly up-regulated in patients with invasive CSCC compared with those with CSCC in situ (Z =3.02,P ＜ 0.01),but were not significantly different among patients with invasive CSCC at different degrees of differentiation (P ＞ 0.05).CSCC patients with lymphatic metastasis showed significantly higher serum levels of SDC1 compared with those without (Z =5.30,P ＜ 0.01).The serum levels of soluble SDC1 were significantly negatively correlated with its tissue levels in CSCC patients (rs =-0.625,P ＜ 0.01).Receiver operating characteristic (ROC) curve analysis showed that the best cutoff point of serum SDC 1 levels was 65.5 μg/L for the diagnosis of lymphatic metastasis,with the sensitivity,specificity and area under the curve (AUC) being 73.7％,87.1％ and 0.904 (0.840-0.968) respectively.Conclusion The downregulated tissue expression but up-regulated serum levels of SDC 1 may be associated with the invasiveness of CSCC,and elevated serum SDC 1 levels are somewhat valuable to the diagnosis of lymphatic metastasis.