循环血内皮细胞微粒对晚期肺癌疗效的预测价值  

Circulating endothelial microparticles for prediction of therapeutic effect in advanced lung cancer

作　　者：刘婷婷[1] 王江 崔鹏飞 李涛[3] 侯柏村 张素洁[3] 胡毅[3] Liu Tingting;Wang Jiang;Cui Pengfei;Li Tao;Hou Baicun;Zhang Sujie;Hu Yi(Department of Respiratory Medicine,Second Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Respiratory Medicine,First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Oncology,Frist Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心呼吸科,100853 [2]解放军总医院第一医学中心呼吸科,100853 [3]解放军总医院第一医学中心肿瘤科,100853

出　　处：《中华肿瘤杂志》2020年第9期723-728,共6页Chinese Journal of Oncology

基　　金：国家重点研发计划(2017YFC0907904)。

摘　　要：目的:探讨循环血内皮细胞微粒(EMPs)与晚期肺癌疾病进展(PD)的关系及其对疗效的预测价值。方法:收集2018年10月至2019年5月解放军总医院第一医学中心肿瘤科常规治疗的88例晚期肺癌患者资料,检测治疗前血常规、乳酸脱氢酶(LDH)、肿瘤标志物以及CD105+EMPs的表达情况。采用流式细胞仪检测CD105+EMPs数目,采用多因素logistic回归分析晚期肺癌进展的预测指标。结果:88例晚期肺癌患者中,客观反应组60例,PD组28例。两组患者的性别、年龄、基础疾病史、肿瘤分期、肿瘤类型、治疗方案等差异均无统计学意义(均P>0.05),两组患者细胞角蛋白19片段、神经元特异性烯醇化酶、LDH、总微粒(MPs)、CD105+EMPs的差异均有统计学意义(均P<0.05)。logistic多因素回归分析结果显示,CD105+EMPs≥70 events/μl(OR=3.623,95%CI为1.345~9.761,P=0.011)和LDH(OR=1.008,95%CI为1.001~1.015,P=0.032)能够预测晚期肺癌的进展。根据多因素回归分析结果建立预测晚期肺癌进展模型,受试者工作特征曲线示,曲线下面积为0.729(95%CI为0.620~0.837,P=0.001),敏感度为32.1%,特异度为91.6%,阳性预测值为64.2%,阴性预测值为74.3%。结论:CD105+EMPs与晚期肺癌进展相关,CD105+EMPs联合LDH能够预测晚期肺癌的疗效。Objective To explore the correlation of endothelial microparticles and progression of advanced lung cancer,and its predictive value in therapeutic effect.Methods The data of patients with advanced lung cancer in the Oncology Department of Frist Medical Center of Chinese PLA General Hospital from October 2018 to May 2019 were collected.Blood routine,lactate dehydrogenase(LDH),tumor markers,and circulating endothelial microparticles(CD105+EMPs)were measured before treatment.Flow cytometry was used to detect the number of CD105+EMPs,and multivariate regression analysis was used to study the predict factors of advanced lung cancer progression.Results A total of 88 patients were recruited in the study,including 60 in the objective response(OR)group and 28 in the disease progression(PD)group.There were no significant differences in gender,age,basic diseases,tumor stage,cancer type and therapeutic intervention between two groups,while there were significant differences in tumor marker,LDH,total microparticles(MPs),and endothelial microparticles(CD105+EMPs)between two groups(P<0.05).In the multivariate regression analysis,CD105+EMPs≥70 events/μl(OR=3.623,95%CI=1.345~9.761,P=0.011)and LDH(OR=1.008,95%CI=1.001~1.015,P=0.032)were able to predict the progression of advanced lung cancer.A predictive model of advanced lung cancer progression was established based on the multivariate regression results.The area under the receiver operating characteristic curve(AUC)was 0.729(95%CI=0.620~0.837,P=0.001),the sensitivity was 32.1%,the specificity was 91.6%,the positive predictive value was 64.2%,and the negative predictive value was 74.3%.Conclusion Circulating endothelial microparticles are associated with the progression of advanced lung cancer,it combined with LDH can predict the therapeutic effect of advanced lung cancer.

关 键 词：肺肿瘤 晚期 内皮细胞微粒 进展 预测 

分 类 号：R734.2[医药卫生—肿瘤]