Abstract:

Sun Yi, Wang Zhenhua, Wang Rongrong, Zhang Yunxiang Department of Dermatology, Weifang People′s Hospital, Weifang 261041, Shandong, China（Sun Y, Wang ZH）; Clinical Laboratory, Weifang People′s Hospital, Weifang 261041, Shandong, China（Wang RR）; Department of Pathology, Weifang People′s Hospital, Weifang 261041, Shandong, China （Zhang YX） Corresponding author: Wang Zhenhua, Email: wfzcwzh@126.com 【Abstract】 Objective To measure serum and tissue levels of soluble syndecan-1 （SDC1） in patients with cutaneous squamous cell carcinoma （CSCC）, and to explore the relationship between the expression of SDC1 and clinicopathologic features of CSCC as well as between the serum and tissue levels of SDC1. Methods An immunohisto-chemical study was performed to measure SDC1 expression in the epidermis of lesional specimens from 93 patients with CSCC and normal skin specimens from 30 healthy human controls, and enzyme-linked immunosorbent assay （ELISA） to detect serum levels of soluble SDC1 in 81 patients with CSCC and 30 healthy human controls. Results The expression of SDC1 was significantly lower in CSCC tissues than in normal skin tissues （Z = 3.85, P < 0.01）. The expression intensity of SDC1 decreased with the increase in tumor thickness but with the decrease in degree of differentiation of CSCC （χ2 = 11.66, 12.51 respectively, both P < 0.01）. Furthermore, the expression of SDC1 was significantly lower in lesional tissues of CSCC with lymph node metastasis than in those without （Z = 2.20, P < 0.05）. As ELISA showed, serum levels of soluble SDC1 were significantly higher in patients with CSCC than in healthy controls （Z = 4.12, P < 0.01）, and gradually increased with the increase in tumor thickness and with advancing clinical stages of CSCC. In addition, serum levels of SDC1 were significantly up-regulated in patients with invasive CSCC compared with those with CSCC in situ （Z = 3.02, P < 0.01）, but were not significantly different among patients with invasive CSCC at different degrees of differentiation （P > 0.05）. CSCC patients with lymphatic metastasis showed significantly higher serum levels of SDC1 compared with those without （Z = 5.30, P < 0.01）. The serum levels of soluble SDC1 were significantly negatively correlated with its tissue levels in CSCC patients （rs = －0.625, P < 0.01）. Receiver operating characteristic （ROC） curve analysis showed that the best cut-off point of serum SDC1 levels was 65.5 μg/L for the diagnosis of lymphatic metastasis, with the sensitivity, specificity and area under the curve（AUC） being 73.7%, 87.1% and 0.904（0.840 - 0.968） respectively. Conclusion The down-regulated tissue expression but up-regulated serum levels of SDC1 may be associated with the invasiveness of CSCC, and elevated serum SDC1 levels are somewhat valuable to the diagnosis of lymphatic metastasis.