| Objective To detect the serum lipocalin-2(LCN2) and latent transforming growth factor beta binding protein 2(LTBP2) in patients with esophageal squamous cell carcinoma, and to explore the relationship between LCN2, LTBP2 with the clinical pathological features and prognosis of patients. Methods A prospective study design was employed, enrolling 110 patients with esophageal squamous cell carcinoma who were treated at Cangzhou People,s Hospital between April 2018 and December 2019 as the cancer group. Concurrently, 110 healthy individuals undergoing routine physical examinations were recruited as the healthy control group. Serum samples were collected from both groups at enrollment to measure LCN2 and LTBP2 levels. The cancer group underwent a 5-year follow-up, during which patients were categorized into a survival group(86 cases) and a mortality group(24 cases) based on follow-up outcomes. A Cox proportional hazards regression model was used to analyze the factors associated with patient mortality; time-dependent receiver operating characteristic(ROC) curves were used to assess the predictive value of serum LCN2 and LTBP2 levels for patient mortality. Kaplan-Meier analysis was used to construct survival curves for patients. Results Serum LCN2 and LTBP2 levels were higher in the cancer group than in the healthy group(P<0.05). Esophageal squamous cell carcinoma patients with TNM stage Ⅲ, T3-T4 infiltration depth, low differentiation degree, lymph node metastasis, and tumor size>5 cm had higher serum LCN2 and LTBP2 than patients with TNM stage Ⅰ+Ⅱ, T1-T2 infiltration depth, medium/high differentiation degree, no lymph node metastasis, and tumor size ≤ 5 cm(P<0.05). The death group had higher serum LCN2 and LTBP2 than the survival group(P<0.05). Multivariate Cox regression(adjusted for Ridge regression) showed that elevated LCN2 and LTBP2 levels were risk factors for mortality in patients with esophageal squamous cell carcinoma(P<0.05). LCN2 and LTBP2 had some predictive value for mortality in patients with esophageal squamous cell carcinoma; their predictive value tended to increase with prolonged follow-up, and the AUC of the combined predictor was significantly higher than that of LCN2 or LTBP2 alone(P<0.05). Patients with low LCN2 and LTBP2 had higher 5-year survival rates than those with high LCN2 and LTBP2(P<0.05). Conclusion Serum LCN2 and LTBP2 are elevated in patients with esophageal squamous cell carcinoma, and they are related to TNM staging, infiltration depth, differentiation degree, lymph node metastasis, and tumor size. The joint of serum LCN2 and LTBP2 can predict mortality, and patients with higher serum LCN2 and LTBP2 have lower 5-year survival rates. |
