背景:皮肤鳞状细胞癌(cSCC)和皮肤基底细胞癌(cBCC)是非黑色素瘤皮肤癌(NMSC)的最常见类型。NACHT,认为含有LRR和PYD结构域的蛋白1(NLRP1)蛋白在NMSC中被抑制,尽管临床证据仍然缺乏。
目的:探讨NLRP1在cSCC和cBCC患者中的临床意义。
方法:本前瞻性观察性研究纳入了2018年1月至2019年1月到我院就诊的199例cBCC和cSCC患者。此外,收集健康个体的199份血液样品作为对照。然后使用酶联免疫吸附测定(ELISA)测量血清NLRP1和CEA和CYFRA21-1的癌症生物标志物。从患者收集的临床特征包括年龄,性别,BMI,TNM阶段,癌症类型,淋巴结转移,和子宫肌层浸润条件。所有患者均随访1~3年。
结果:在所有患者中,23人在随访期间死亡,死亡率为11.56%。与健康对照相比,癌症患者的血清NLRP1水平明显较低。此外,与cSCC患者相比,cBCC患者中NLRP1的表达明显更高。死去的病人,连同淋巴结转移和肌层浸润的患者,还显示出显著较低的NLRP1水平。此外,较低的NLRP1水平与较高的肿瘤结节转移(TNM)III-IV分期相关,淋巴结转移和肌层浸润,以及更高的死亡率和复发率。曲线回归显示,NLRP1与CEA/或CYFRA21-1之间的关系最合适。受试者工作特征(ROC)曲线显示NLRP1是淋巴结转移的潜在生物标志物,NMSC患者的肌层浸润和预后,Kaplan-Meier分析发现NLRP1与NMSC1-3年死亡率和复发相关。
结论:在cSCC和cBCC患者中,较低的NLRP1水平与较差的临床结局和较差的预后相关。
BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) and cutaneous basal cell carcinoma (cBCC) are the most common types of non-melanoma skin cancer (NMSC). The NACHT, LRR and PYD domains-containing protein 1 (
NLRP1) protein is considered to be inhibited in NMSC, although clinical evidence is still lacking.
OBJECTIVE: To investigate the clinical significance of
NLRP1 in cSCC and cBCC patients.
METHODS: This prospective observational study enrolled 199 cases of cBCC and cSCC patients who reported to our hospital from January 2018 to January 2019. Additionally, 199 blood samples from healthy individuals were collected as the control. Serum NLRP1 and cancer biomarkers of CEA and CYFRA21-1 were then measured using enzyme-linked immunosorbent assay (ELISA). Clinical characteristics collected from patients included age, sex, BMI, TNM stage, cancer type, lymph node metastasis, and myometrial infiltration conditions. All patients were followed up for 1-3 years.
RESULTS: Of all patients, 23 died during the follow-up period, with a mortality rate of 11.56%. Serum
NLRP1 showed markedly lower levels in cancer patients compared with healthy controls. Furthermore, the expression of NLRP1 was significantly higher in cBCC patients compared with cSCC patients. The deceased patients, together with those with lymph node metastasis and myometrial infiltration, also showed significantly lower NLRP1 levels. Moreover, lower
NLRP1 levels were associated with higher frequencies of tumor-nodule-metastasis (TNM) III-IV stage, lymph node metastasis and myometrial infiltration, as well as higher mortality and recurrence rates. The curvilinear regression showed the relationship between NLRP1 and CEA/or CYFRA21-1 was most appropriate for the reciprocal. Receiver operating characteristic (ROC) curves showed
NLRP1 was a potential biomarker for lymph node metastasis, myometrial infiltration and prognosis in NMSC patients, and the Kaplan-Meier analysis found NLRP1 was associated with 1-3-year mortality and recurrence of NMSC.
CONCLUSIONS: Lower NLRP1 level is associated with worse clinical outcomes and poorer prognosis in cSCC and cBCC patients.