Expression of LOXL4 in laryngeal squamous cell carcinoma and its significance in evaluating chemotherapy response and prognosis

HUANG Xiao-bo; YAO Mei; LU Xin-hong; ZHANG Wei-shi; YAO Li; DING Lian

doi:10.13820/j.cnki.gdyx.20251705

Abstract：Objective To investigate the expression characteristics of lysyl oxidase-like protein 4(LOXL4)in patients with laryngeal squamous cell carcinoma(LSCC)and to evaluate its significance in assessing chemotherapy effica-cy and prognosis.Methods A total of 212 patients with pathologically confirmed LSCC admitted between January 2021 and July 2023 were included.All patients completed at least four cycles of combination chemotherapy and were followed for 12 months at 1-2-month intervals.Based on outcomes,patients were classified into a good-prognosis group and a poor-prognosis group.Clinical and pathological features,chemotherapy parameters,LOXL4 transcription and protein lev-els in tumor tissues,and serum LOXL4 concentrations were compared between groups.Multivariate logistic regression was used to identify independent risk factors for poor prognosis.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of LOXL4 alone and in combination with other variables.Results Among the 212 patients(age 40-74 years,median 62 years;145 males,67 females),102(49.1％)had poor prognosis within 1 year after chemotherapy.Compared with the good-prognosis group,the poor-prognosis group had higher mean age,smoking his-tory rate,diabetes comorbidity rate,proportion of supraglottic tumors,maximum tumor diameter,stage Ⅳ disease,poorly differentiated tumors,lymph node metastasis,tumor LOXL4 transcription level,LOXL4-positive rate,and serum LOXL4 level,while receiving fewer chemotherapy cycles(all P＜0.05).Multivariate logistic regression identified smoking history(OR=2.665,95％CI:1.299-5.466),tumor maximum diameter(OR=2.559,95％CI:1.477-4.433),lymph node metastasis(OR=2.460,95％CI:1.154-5.245),tumor LOXL4 transcription level(OR=6.973,95％CI:2.877-16.900),LOXL4 positivity/strong positivity(OR=1.632,95％CI:1.093-2.439),and serum LOXL4 level(OR=1.110,95％CI:1.050-1.174)as independent risk factors for poor prognosis(all P＜0.05).ROC analysis showed that the AUCs for predicting poor prognosis using smoking history,tumor size,lymph node metastasis,tumor LOXL4 transcrip-tion,LOXL4 positivity,and serum LOXL4 were 0.572,0.648,0.575,0.699,0.616,and 0.667,respectively,while combined prediction yielded an AUC of 0.831(Z=4.532,3.896,4.527,3.701,4.032,3.794,P＜0.05),with a sensitivity of 70.46％and specificity of 85.35％.Conclusion Elevated LOXL4 expression in tumor tissues and serum is an independent risk factor for poor chemotherapy prognosis in LSCC patients.The combination of LOXL4 level with smok-ing history,tumor size,and lymph node metastasis provides a robust predictive model for chemotherapy outcomes.