The Expression And Clinical Significance Of Chemerin In Patients With Oral Squamous Cell Carcinoma Complicated By Type 2 Diabetes

Objective:This study aimed to elucidate the expression and clinical significance of Chemerin in patients with oral squamous cell carcinoma(OSCC)complicated by type 2diabetes(T2DM),and provide a potential treatment strategy to improve the prognosis of oral cancer patients with T2 DM.Methods:The study population consisted of 200 patients from 2009 to 2014 who underwent surgery at the Affiliated Hospital of Qingdao University and were diagnosed with squamous cell carcinoma of the oral cavity.The patients,consisted of 87 cases complicated by type 2 diabetes and 113 patients without type 2 diabetes,were divided into T2 DM group and control group.Blood specimens were collected from eligible OSCC patients admitted from July 2021 to December 2021.Immunohistochemistry(IHC)and Enzyme linked immunosorbent assay(ELISA)were adopted to detect the expression of Chemerin in the tumor sections and the serum of patients(high expression v.s.low expression).The associations among clinic-pathologic factors and Chemerin expression were evaluated using the chi-square test.Kaplan–Meier and a univariate log-rank tests were used to construct the survival curve and compare prognostic difference,respectively.A multivariate model affecting the survival of OSCC patients with type 2 diabetes was performed using a stepwise forward Cox proportional hazards regression.For all analyses,a P value less than 0.05 was considered significant.Results:(1)IHC and ELISA showed that the expression of Chemerin in T2 DM group was higher than that of control group(P<0.05).The high expression of Chemerin in T2 DM group was associated with lymph node metastasis(X2=6.420,P<0.05),TNM stage(X2=9.854,P < 0.05),tumor differentiation(X2=7.958,P<0.05)and tumor recurrence(X2=4.304,P<0.05).(2)Kaplan–Meier and log-rank analysis revealed that the patients with high Chemerin expression in T2 DM group had a significantly shorter 5-year overall survival(OS)than those of designed groups(P<0.05).Thus,elevated Chemerin level was associated with the worse survival outcome of oral cancer patients with T2 DM.(3)The univariate survival analysis revealed that the Chemerin expression was a prognostic predictor for the overall survival of OSCC patients with type 2 diabetes(P=0.001).By using multivariate comparison,we further identified that the Chemerin represented an independent prognostic factor for OS of OSCC patients with type 2diabetes.Conclusion:In conclusion,the histological studies from clinical samples disclose that Chemerin is a novel prognostic marker for the survival outcome of oral cancer patients with type 2diabetes.We hope that our work could provide a new idea for the treatment of OSCC patients with type 2 diabetes.