肺癌根治术后患者预后的影响因素分析

doi:10.3969/j.issn.1671-7171.2022.08.019

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1183 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要【目的】探讨肺癌根治术后患者预后的影响因素。【方法】选择2019年6月至2021年6月在本院接受肺癌根治术的160例患者,术后随访30个月,根据预后情况分为预后不良组(随访期间死亡或肿瘤转移,n=55)和预后良好组(随访期间未死亡或肿瘤未转移,n=105)。收集并比较两组患者术前白蛋白(ALB)、红细胞体积分布宽度(RDW)等临床基线资料及血清增殖细胞核抗原(PCNA)、切除修复交叉互补基因1(ERCC1)、细胞角蛋白19片段抗原21-1(CYFRA21-1)水平,多因素Logistic回归分析影响肺癌根治术后患者预后的危险因素,受试者工作特征(ROC)曲线分析血清PCNA、ERCC1、CYFRA21-1联合临床特征对肺癌根治术后患者预后不良的预测效能。【结果】预后不良组患者年龄≥60岁、TNM分期为Ⅲ～Ⅳ期、术前ALB＜35 g/L、术前RDW＞12.95%占比及术前PCNA、CYFRA21-1水平显著高于预后良好组(P<0.05),术前ERCC1水平显著低于预后良好组(P<0.05)。年龄≥60岁、TNM分期为Ⅲ～Ⅳ期、术前ALB＜35 g/L、术前RDW＞12.95%、术前PCNA≥396.20 pg/mL、ERCC1≤74.85 ng/mL、CYFRA21-1≥9.00 ng/mL是肺癌根治术后患者预后不良的独立危险因素(P<0.05)。血清PCNA、ERCC1、CYFRA21-1联合年龄、TNM分期、ALB、RDW对肺癌根治术后患者预后不良有一定的预测价值,ROC曲线下面积为0.945,预测敏感度为0.909,特异度为0.981。【结论】肺癌根治术后患者预后受较多因素影响,包括年龄、TNM分期、ALB、RDW及PCNA、ERCC1、CYFRA21-1,其中血清PCNA、ERCC1、CYFRA21-1可作为预测肺癌根治术后患者预后的可靠生物标志物,且其联合上述其他指标可提高预测效能。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	高娜
	常静

关键词 ：肺肿瘤/外科学, 增殖细胞核抗原/血液, 角蛋白质类/血液, 预后

Abstract：【Objective】 To explore the prognostic factors of patients with lung cancer after radical resection. 【Methods】A total of 160 patients who underwent radical resection of lung cancer in our hospital from June 2019 to June 2021 were selected and followed up for 30 months. According to the prognosis, they were divided into poor prognosis group (death or metastasis at other sites during follow-up, n=55) and good prognosis group (no death or metastasis at other sites during follow-up, n=105). The clinical baseline data such as preoperative albumin (ALB), red blood cell volume distribution width (RDW) and the levels of serum proliferating cell nuclear antigen (PCNA), excision repair cross complementary gene 1 (ERCC1) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) were collected and compared between the two groups. Multivariate logistic regression was used to analyze the risk factors of prognosis of patients with lung cancer after radical resection.The predictive efficacy of serum PCNA, ERCC1 and CYFRA21-1 combined with clinical characteristics on poor prognosis of patients with lung cancer after radical resection was analyzed by receiver operating characteristic (ROC) curve.【Results】 The age≥60 years, TNM stage Ⅲ ～ Ⅳ, preoperative ALB＜35 g/L, preoperative RDW＞12.95%, preoperative PCNA and CYFRA21-1 levels in the poor prognosis group were significantly higher than those in the good prognosis group (P<0.05), and the preoperative ERCC1 levels were significantly lower than those in the good prognosis group (P<0.05). Age≥60 years, TNM stage Ⅲ～Ⅳ, preoperative ALB<35 g/L, preoperative RDW > 12.95%, preoperative PCNA≥396.20 pg/mL, ERCC1 ≤74.85 ng/mL, CYFRA21-1≥9.00 ng/mL were independent risk factors for poor prognosis of patients with lung cancer after radical resection (P<0.05). Serum PCNA, ERCC1, CYFRA21-1 combined with age, TNM stage, ALB and RDW have certain predictive value for poor prognosis of patients with lung cancer after radical resection. The area under the ROC curve is 0.945, the predictive sensitivity is 0.909, and the specificity is 0.981. 【Conclusion】 The prognosis of patients with lung cancer after radical resection is affected by many factors, including age, TNM stage, ALB, RDW, PCNA, ERCC1 and CYFRA21-1. Among them, serum PCNA, ERCC1 and CYFRA21-1 can be used as reliable biomarkers to predict the prognosis of patients with lung cancer after radical resection, and their combination with the above other indicators can improve the prediction efficiency.

Key words： Lung Neoplasms/SU Proliferating Cell Nuclear Antigen/BL Keratins/BL Prognosis

收稿日期: 2022-02-24

中图分类号:

R734.2

通讯作者: *E-mail:chang8125jing@163.com

引用本文:

高娜, 常静. 肺癌根治术后患者预后的影响因素分析[J]. 医学临床研究, 2022, 39(8): 1190-1193.
GAO Na, CHANG Jing. Analysis of Prognostic Factors of Patients with Lung Cancer after Radical Resection. JOURNAL OF CLINICAL RESEARCH, 2022, 39(8): 1190-1193.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.08.019 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I8/1190

[1] 陈亦晨,孙良红,李小攀,等. 2010-2018年上海市浦东新区居民肺癌死亡空间流行病学特征分析[J].中华肿瘤防治杂志,2020,27(13):1021-1028.
[2] 王泽洲,张扬,莫淼,等. 大型单中心医院登记的7753例肺癌手术患者生存报告:基于第8版国际肺癌TNM分期标准[J].中国癌症杂志,2020,30(5):321-327.
[3] CHEN X,SUN J,WANG Y. Expressions of CD44,PCNA and MRP1 in lung cancer tissues and their effects on proliferation and invasion abilities of lung cancer cell line 95D[J].J BUON,2021,26(1):72-78.
[4] OKUDA K,TATEMATSU T,YANO M,et al. The relationship between the expression of thymidylate synthase,dihydropyrimidine dehydrogenase,orotate phosphoribosyltransferase,excision repair cross-complementation group 1 and class Ⅲ β-tubulin,and the therapeutic effect of S-1 or carboplatin plus paclitaxel in non-small-cell lung cancer[J].Mol Clin Oncol,2018,9(1):21-29.
[5] NASIM F,SABATH B F,EAPEN G A. Lung cancer[J].Med Clin North Am,2019,103(3):463-473.
[6] 车强,汪林宝,王孝彬,等. 胸腔镜肺癌根治术后肺部并发症发生风险分析[J].医学临床研究,2020,17(11):1667-1670.
[7] 贺竞,龙翔宇,王颖,等. 肺癌根治术患者血清EGFR、ALK、ROS1基因表达与预后的关系[J].标记免疫分析与临床,2021,28(7):1170-1174.
[8] SCHABATH MB,COTE ML. Cancer progress and priorities:lung cancer[J].Cancer Epidemiol Biomarkers Prev,2019,28(10):1563-1579.
[9] 李婵,李涛. 老年非小细胞肺癌患者预后影响因素分析[J].中华肿瘤防治杂志,2020,27(22):1844-1849.
[10] 张华,张彬,高留伟,等. 术前红细胞分布宽度对非小细胞肺癌患者预后的评估价值[J].中国肿瘤临床,2018,45(13):682-686.
[11] 田含含,周锡垒,陈炜,等. 调强放疗联合化疗对晚期非小细胞肺癌血清三种因子表达变化的队列研究[J].中华放射肿瘤学杂志,2021,30(10):1007-1012.
[12] 罗洞波,赵书源,何丹. ERCC1的表达与非小细胞肺癌根治术后患者的预后相关性研究[J].福建医科大学学报,2018,52(1):12-18.
[13] 刘洋,陈耀辉,刘建刚,等. 早期非小细胞肺癌患者血清ERCC1水平与疗效、预后的关系[J].山东医药,2017,57(32):76-78.
[14] LI B,YUAN Q,ZOU Y T,et al. CA-125,CA-153,and CYFRA21-1 as clinical indicators in male lung cancer with ocular metastasis[J].J Cancer,2020,11(10):2730-2736.