治疗前血清载脂蛋白水平与小细胞肺癌患者预后的相关性研究  

Correlation between Pretreatment Serum Apolipoprotein Level and Prognosis of Small Cell Lung Cancer Patients

作　　者：董娅 王浩澄 单东凤 张林薇 于壮[1] Ya DONG;Haocheng WANG;Dongfeng SHAN;Linwei ZHANG;Zhuang YU(Department of Oncology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院肿瘤科,青岛266003

出　　处：《中国肺癌杂志》2020年第10期845-851,共7页Chinese Journal of Lung Cancer

摘　　要：背景与目的肺癌为癌症相关死亡的主要原因,在所有类型的肺癌中,小细胞肺癌(small cell lung cancer, SCLC)预后极差,本研究评估SCLC患者血清载脂蛋白水平与预后的关系,寻求指导SCLC诊治的新指标。方法本研究回顾性分析了122例SCLC患者的临床资料。收集治疗前2周内血清载脂蛋白水平患者的临床结果,主要包括载脂蛋白(apolipoprotein, Apo)A-I、ApoB以及ApoB/ApoA-I。患者的无进展生存期(progression free survival, PFS)和总生存期(overall survival, OS)是主要的结局指标。用X-tile工具确定各指标的最佳临界值,生存分析采用KaplanMeier法分析,采用Cox回归分析法进行单因素分析和多因素分析。结果与低ApoA-I水平组的患者相比,高ApoA-I水平组(ApoA-I>1.12 g/L)的患者具有更好的OS(21.5个月vs 12.3个月,P=0.007)和PFS(7.3个月vs 5.5个月,P=0.017)。相反,具有较高ApoB/ApoA-I水平的患者比ApoB/ApoA-I水平较低的患者的中位OS差(13.4个月vs 20.7个月,P=0.012)。多因素Cox回归分析表明,ApoA-I是影响SCLC患者PFS的独立预后因素(HR=0.67, 95%CI:0.45-0.99,P=0.043)。ApoB/ApoA-I是影响SCLC患者OS的独立危险因素(HR=1.98, 95%CI:1.21-3.23, P=0.007)。结论治疗前血清ApoA-I水平和ApoB/ApoA-I水平可能是SCLC的重要预后因素,有助于判断患者的预后。Background and objective Lung cancer is the leading cause of cancer-related death, and small cell lung cancer(SCLC) has a poor prognosis in all types of lung cancer. This study evaluated the relationship between pretreatment serum apolipoprotein levels and prognosis in patients with SCLC, seeks a new index can guide diagnosis and treatment of SCLC. Methods This study retrospectively analyzed the clinical data of 122 patients with SCLC. The clinical results of patients with serum apolipoprotein levels within 2 weeks before treatment were collected, including apolipoprotein AI(ApoA-I), apolipoprotein B(ApoB), and the ratio of apolipoprotein B to apolipoprotein AI(ApoB/ApoA-I). Patients’ progression-free survival(PFS) and overall survival(OS) are the main outcome indicators. The best critical to determine the index’s value by X-tile tool. For survival analysis, Kaplan-Meier method was used for analysis, and Cox regression analysis method was used for single factor analysis and multifactor analysis. Results Compared with patients with low ApoA-I levels, patients with high ApoA-I levels(ApoA-I>1.12 g/L) had better OS(21.5 mon vs 12.3 mon, P=0.007) and PFS(7.3 mon vs 5.5 mon, P=0.017). In contrast, patients with higher ApoB/ApoA-I levels had worse median OS than patients with lower ApoB/ApoA-I levels(13.4 mon vs 20.7 mon, P=0.012). Multivariate Cox regression analysis showed that ApoA-I was an independent prognostic factor affecting PFS in SCLC patients(HR=0.67, 95%CI: 0.45-0.99, P=0.043). ApoB/ApoA-I is an independent risk factor for OS in patients with SCLC(HR=1.98, 95%CI: 1.21-3.23, P=0.007). Conclusion Serum ApoA-I level and ApoB/ApoA-I level before treatment can be important prognostic factors for SCLC, which is helpful to judge the prognosis of patients.

关 键 词：肺肿瘤 载脂蛋白A-I 载脂蛋白B/载脂蛋白A-I 预后 

分 类 号：R734.2[医药卫生—肿瘤]