CD14^+/HLA-DR^+及纤维蛋白原在肺癌中的表达及其与预后的关系  

Levels of CD14^+/HLA-DR^+ and fibrinogen in lung cancer and their correlations with prognosis

作　　者：熊娟[1] 张剑英[1] 张毅敏[1] 陶开义[2] 徐笑红[1] XIONG Juan;ZHANG Jian-ying;ZHANG Yi-min;TAO Kai-yi;XU Xiao-hong(Clinical Laboratory,Xhejiang Cancer Hospital,Hangzhou,Zhejiang 310022,China)

机构地区：[1]浙江省肿瘤医院检验科,浙江杭州310022 [2]浙江省肿瘤医院胸部肿瘤外科,浙江杭州310022

出　　处：《中国卫生检验杂志》2019年第1期54-58,共5页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医药卫生科技项目(2016KYA044)

摘　　要：目的观察外周血CD14^+单核细胞中人白细胞DR抗原(CD14^+/HLA-DR^+)表达水平及纤维蛋白原(Fib)浓度变化,探讨炎性标记物检测对肺癌患者预后的评估价值。方法应用流式细胞术及免疫比浊法检测CD14^+/HLA-DR^+水平及Fib浓度,并分析其与肿瘤病理特征及无病生存期的相关性。结果肺癌外周血中CD14^+/HLA-DR^+的水平较对照组明显降低(t=-3.174,P <0.01),而Fib浓度较对照组明显升高(t=3. 46,P <0. 01);肺癌患者CD14^+/HLA-DR^+水平与Fib浓度呈负相关性(r=-0.515,P <0. 01)。患者治疗前CD14^+/HLA-DR^+水平与吸烟史、TNM分期、淋巴结转移有关(P <0. 05),Fib浓度与吸烟史、TNM分期、淋巴结转移、肿块大小、脉管癌栓及病理类型等有关(P <0. 05)。在肺癌中,CD14^+/HLA-DR^+低表达水平组和(或) Fib高浓度组的患者无病生存期明显降低(P <0. 01); Cox比例风险模型多因素分析显示,TNM分期及CD14^+/HLA-DR^+水平是影响肺癌患者无病生存期的独立预后因素(P <0. 01)。结论 CD14^+/HLA-DR^+水平及Fib浓度可作为判断肺癌恶性程度的指标; TNM分期及CD14^+/HLA-DR^+水平是影响肺癌患者无病生存期的独立预后因素。Objective To study the detection of inflammatory markers on the prognosis of patients with lung cancer through detecting the expression of human leukocyte antigen DR(CD14^+/HLA-DR^+)in CD14^+ monocytes of peripheral blood and the changes of fibrinogen (Fib)concentrations.Methods The levels of CD14^+/HLA-DR^+ monoeytes and plasma Fib were analyzed by flow eytometry and immunoturbidimetry;and its relationship with elinicopathologic characteristics and prognostic for disease-free survival (DFS)were analyzed.Results The levels ofCD14^+/HLA-DR^+ monocytes in lung cancer patients were significantly lower than those in healthy controls (t =-3.174,P <0.01),while the Fib levels were significantly higher than those in controls (t =3.46,P <0.01);the levels of CD14^+/HLA-DR^+ monocytes was negatively correlated with Fib concentrations in patients with lung cancer (r =-0.515,P <0.01).The levels of CD14^+/HLA-DR^+ monoeytes before treatment were related with smoking history,TNM stage,and lymph node metastasis (P <0.05);Fib concentration was correlated with smoking history,TNM stage,lymph node metastasis,tumor size,vascular tumor thrombus and different histological classifications (P <0.05).The low level of CD14^+/HLA-DR^+ monocytes and/or hyperfibrinogenemia had a worse prognostic significance to patients'disease-free survival(DFS)time (P <0.01);Cox multivariate regression analysis revealed that TNM stage and CD14^+/HLA-DR^+ monocytes level were independent predictive factors for decreased DFS (P < 0.01).Conclusion The level of CD14^+/HLA-DR^+ monocytes and Fib concentration can be promising biomarkers for evaluating the progression of lung cancer;TNM stage and CD14^+/HLA-DR^+ monocytes level are independent prognositic factors affecting DFS in lung cancer patients.

关 键 词：肺癌 CD14 HLA—DR抗原 纤维蛋白原 预后 

分 类 号：R734.2[医药卫生—肿瘤]