根治性放化疗疗程中血清HSP70变化轨迹对子宫颈鳞癌患者预后的预测效能OA

Objective To explore the predictive efficacy of the serum heat shock protein 70(HSP70)change trajectory during the radical radiotherapy and chemotherapy(CRT)course for the prognosis of pa-tients with cervical squamous cell carcinoma(CSCC).Methods A total of 203 patients with CSCC who were scheduled for CRT treatment in the hospital from July 2020 to July 2024 were selected as the research sub-jects.Serum HSP70 level was detected before treatment,1 treatment cycle later and at the end of the treat-ment cycle.The latent class trajectory model(LCTM)was used to analyze the serum HSP70 change trajecto-ry during the CRT course and establish a trajectory model.The Kaplan-Meier survival curve was used to com-pare the survival curves of different trajectory groups.Multivariate COX regression analysis was used to ana-lyze the influencing factors of the prognosis of CSCC patients.The risk prediction model assessment was used to evaluate the value of the serum HSP70 changes trajectory during the CRT course in predicting the progno-sis of CSCC patients.Results The serum HSP70 levels of all subjects before treatment,1 treatment cycle lat-er,and at the end of the treatment cycle were(101.25±28.47)ng/mL,(83.02±24.96)ng/mL and(67.66±15.20)ng/mL respectively.LCTM analysis showed that the optimal model was obtained when the number of potential classes was 3,and 3 trajectory groups were obtained at this time.In the T1 group,65 cases(32.02％)had a rapid decrease in serum HSP70 levels during the CRT course,in the T2 group,67 cases(33.00％)had a decrease from a medium-low level during the CRT course,and in the T3 group,71 cases(34.98％)maintained a high level of serum HSP70 or showed no significant decrease during the CRT course.There were statistically significant differences in international federation of gynecology and obstetrics(FIGO)stage among the T1,T2,and T3 groups(P＜0.05).During the follow-up period,there were 6 censored cases.The Kaplan-Meier survival curve analysis showed that after Log-Rank x2 test,the overall comparison of the survival curves of the three groups was statistically significant(x2=48.305,P=0.001),and the survival rate of the T3 group[37.68％(26/69)]was lower than that of the T2 group[78.46％(51/65)]and the T1 group[92.06％(58/63)],and the survival rate of the T2 group was lower than that of the T1 group,and the differ-ences were statistically significant(P＜0.05).Multivariate COX regression analysis with the T1 group as the reference showed that the death risk of patients in the T2 group was 2.006 times that of the T1 group after adjusting for FIGO stage(P＜0.001),and the death risk of patients in the T3 group was 3.355 times that of the T1 group(P＜0.001).Linear trend test showed that the death risk of the T1 group,T2 group and T3 group increased linearly,and the difference was statistically significant(P＜0.05).Risk prediction model as-sessment showed that when the serum HSP70 changes during the CRT course were at T3,the sensitivity for predicting the death risk was 69.35％,the specificity was 80.74％,the positive predictive value was 62.32％,and the negative predictive value was 85.16％.Conclusion The dynamic changes trajectory of serum HSP70 during the CRT course can effectively predict the prognosis of CSCC patients.Patients with continuous high expression of serum HSP70 have a significantly increased risk of death.This finding provides a reference for screening potential patients who can benefit from CRT.