| 任 磊,王亚辉,韩 明,等.术前血清和尿液CCL27水平在预测非肌层浸润性膀胱癌患者复发和进展风险中的作用[J].肿瘤学杂志,2025,31(8):717-724. |
| 术前血清和尿液CCL27水平在预测非肌层浸润性膀胱癌患者复发和进展风险中的作用 |
| adrenal neoplasms； Mayo adhesive probability score； therapeutic laparoscopy； periadrenal fat； preoperative evaluationThe Role of Preoperative Serum and Urine CCL27 Levels in Predicting the Risk of Recurrence and Progression in Patients with Non-Muscle Invasive Bladder Cancer |
| 投稿时间：2024-09-18 |
| DOI：10.11735/j.issn.1671-170X.2025.08.B010 |
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| 中文关键词: CC趋化因子配体27 膀胱肿瘤 非肌层浸润 复发 进展 |
| 英文关键词:CC chemokine ligand 27 bladder neoplasms non-muscle invasive recurrence progression |
| 基金项目:咸阳市重点研发科研计划（S2022-ZDYF-SF-1062） |
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| 中文摘要: |
| 摘 要： ［目的］ 探讨术前血清和尿液CC趋化因子配体27（CC chemokine ligand 27，CCL27）在预测非肌层浸润性膀胱癌（non-muscle invasive bladder cancer，NMIBC）患者复发和进展风险中的作用。［方法］ 第一阶段：2017年9月10日至12月31日，从咸阳市第一人民医院泌尿外科共招募了15例NMIBC患者作为发现集，完成经尿道膀胱肿瘤切除术（transurethral resection of bladder tumor，TURBT），采集术前血清和尿液样本，通过Bio-Plex多重芯片分析技术检测细胞因子/趋化因子。第二阶段：2018年4月1日至2019年4月1日，招募91例NMIBC患者作为验证集，收集血清和尿液样本进行验证，通过酶联免疫吸附试验法检测血清和尿液CCL27水平。［结果］ 在发现集中，复发与无复发或进展与无进展患者仅CCL27水平差异有统计学意义（P均＜0.05）。在验证集中，复发/进展组术前血清和尿液CCL27水平均显著高于无复发/无进展组（P＜0.05）。血清和尿液CCL27水平预测NMIBC复发的ROC曲线下面积（area under the curve，AUC）分别为0.780［95%置信区间（confidence interval：CI）：0.678～0.881］、0.869（95%CI：0.796～0.942），预测NMIBC进展的AUC分别为0.803（95%CI：0.708～0.897）、0.862（95%CI：0.788～0.936）。Logistic回归分析显示术前尿液CCL27高水平是影响NMIBC复发或进展的独立危险因子（P均＜0.001）。根据ROC曲线确定的截断值将NMIBC患者分为血清或尿液CCL27高水平组和低水平组，随访5年期间，血清和尿液CCL27高水平组患者中位无复发生存期和中位无进展生存期均明显更短（P＜0.001）。［结论］ CCL27水平上调与NMIBC复发和进展密切相关，术前血清和尿液CCL27水平有望作为识别NMIBC复发和进展高风险患者的早期预测标志物，且尿液CCL27的预测效能更优。 |
| 英文摘要: |
| Abstract： ［Objective］ To investigate the role of preoperative serum and urine CC chemokine ligand 27 (CCL27) in predicting the risk of recurrence and progression in patients with non-muscle invasive bladder cancer (NMIBC). ［Methods］ Stage 1： From September 10 to December 31， 2017， a total of 15 NMIBC patients were recruited from the Department of Urology at the First People’s Hospital of Xianyang City as the discovery group to complete transurethral resection of bladder tumor (TURBT). Preoperative serum and urine samples were collected， and cytokines/chemokines were detected using Bio-Flex multiplex chip analysis technology. Stage 2： From April 1， 2018 to April 1， 2019， 91 NMIBC patients were recruited as the validation set， and serum and urine samples were collected for validation. The levels of CCL27 in serum and urine were detected by enzyme-linked immunosorbent assay. ［Results］ In the discovery group， there were significant differences between patients with recurrence and those without recurrence， or between patients with progression and those without progression only at the level of CCL27(all P<0.05). In the verification set， the preoperative serum and urine CCL27 levels in the recurrence / progression group were significantly higher than those in the non-recurrence/progression group (P<0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of serum and urine CCL27 levels for predicting NMIBC recurrence were 0.780 ［95% confidence interval (CI)： 0.678～0.881］ and 0.869 (95%CI： 0.796～0.942)， which predicting the progression of NMIBC were 0.803 (95%CI： 0.708～0.897) and 0.862 (95%CI： 0.788～0.936)， respectively. Logistic regression analysis showed that high level of preoperative urine CCL27 was an independent risk factor for recurrence or progression of NMIBC (all P<0.001). According to the cut-off value determined by the ROC curve， NMIBC patients were divided into groups with high serum or urine CCL27 level and groups with low serum or urine CCL27 level， during 5-year follow-up， median recurrence-freesurvival and median progression-free survival were significantly shorter in patients with high serum and urine CCL27 levels (P<0.001). ［Conclusion］ Upregulation of CCL27 level is closely related to the recurrence and progression of NMIBC. Preoperative serum or urine CCL27 is promising as an early predictor for identifying patients at high risk of recurrence and progression of NMIBC， while the predictive value of urine CCL27 is better. |
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