Objective To study the expression of serum secreted protein acidic and rich in cysteine(SPARC),plas-min activator inhibitor 1(SERPIND1)in patients with nasopharyngeal carcinoma(NPC)and their relationship with radiosensi-tivity and prognosis.Methods Ninety-eight NPC patients diagnosed and treated in the hospital from January 2017 to Janu-ary 2019 were collected as the NPC group,and 60 healthy individuals who underwent physical examinations during the same period were selected as the control group.Enzyme linked immunosorbent assay was used to detect serum SPARC and SER-PIND1 levels.NPC patients were divided into radiation sensitive subgroup and radiation resistant subgroup based on their radiation response.The differences in serum SPARC and SERPIND1 levels among NPC patients with different clinical patho-logical features and radiation response were compared.Kaplan-Meier curves were drawn and the differences between curves of different SPARC and SERPIND1 expression groups were compared using Log-Rank test.COX regression analysis was used to analyze the prognostic factors of NPC.Results The serum SPARC and SERPIND1 levels in the NPC group before radiotherapy were significantly higher than the control group,the difference was statistically significant(t=37.535,48.522,P＜0.001).The serum SPARC and SERPIND1 levels of HPC patients in the radiation resistant subgroup before radiotherapy were significantly higher than those in the radiation sensitive subgroup(t/P=14.034/＜0.001,7.772/＜0.001).After radiother-apy,the serum SPARC and SERPIND1 levels of the two groups were significantly reduced,and the difference was statisti-cally significant(t/P=22.974/＜0.001,18.137/＜0.001).The serum SPARC and SERPIND1 levels of NPC patients with TNM stage Ⅲ-Ⅳ and lymph node metastasis before radiotherapy were higher than those of NPC patients with TNM stage Ⅰ-Ⅱ and no lymph node metastasis(t/P=16.539/＜0.001,16.799/＜0.001,15.756/＜0.001,15.015/＜0.001).The 3-year overall survival rates of patients with high and low serum SPARC expression were 50.00％(24/48)and 92.00％(46/50).The 3-year overall survival rates of patients with high and low serum SERPIND1 expression groups were 53.19％(25/47)and 88.24％(45/51).The 3-year cumulative survival rate of NPC patients in the high expression group of serum SPARC and SERPIND1 was significantly lower than that in the low expression group of serum SPARC and SERPIND1(Log-rank x2=21.500,14.790,P＜0.001).Clinical stages Ⅲ-Ⅳ,lymph node metastasis,high expression of SPARC,and high expression of SERPIND1 were independent risk factors affecting the prognosis of NPC[HR(95％CI)=1.608(1.225-2.112),1.917(1.319-2.799),1.839(1228-2.753),1.738(1.246-2.426)].Conclusion The upregulation of serum SPARC and SERPIND1 levels in NPC patients are related to adverse clinical pathological characteristics and radiation sensitivity,and are serum tumor marker for evaluating the prognosis of NPC patients.
Nasopharyngeal carcinomaSecreted protein acidic and rich in cysteineFibrin activating factor inhibi-tory proteinRadiotherapy sensitivityPrognosis
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