血清肠三叶因子(TFF3)在非小细胞肺癌的诊断及化疗疗效评估中的意义  

Significance of serum Trefoil Factor 3 (TFF3) in the diagnosis and evaluation of chemotherapy efficacy of non-small cell lung cancer

作　　者：常远敏 尤青海[1] CHANG Yuan-min;YOU Qing-hai(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)

机构地区：[1]安徽医科大学第一附属医院呼吸与危重症科,安徽合肥230022

出　　处：《临床肺科杂志》2022年第2期267-271,共5页Journal of Clinical Pulmonary Medicine

基　　金：安徽医科大学中青年学术骨干基金(2013);安徽医科大学第一附属医院后备人才基金(2014)。

摘　　要：目的探讨肠三叶因子(TFF3)在非小细胞肺癌的诊断及化疗疗效评估中的作用,为诊断和治疗非小细胞肺癌提供新的肿瘤标志物。方法选取2020年06月20日至2021年06月06日于安徽医科大学第一附属医院呼吸与危重症科初次确诊的84例非小细胞肺癌患者[肺鳞癌(LUSC)38例),肺腺癌(LUAD)46例]作为非小细胞肺癌组,同一时期在本医院进行体检的21例健康者为对照组,跟踪仅接受培美曲塞(LUAD)或紫杉醇(LUSC)+铂类方案连续化疗2个周期的非小细胞肺癌患者作为化疗组。使用酶联免疫吸附法(ELISA)检测非小细胞肺癌患者初次确诊时、连续化疗2个周期后、健康对照组体检第一天血清TFF3水平。采集非小细胞肺癌患者初次确诊时外周血实验室指标(中性粒细胞计数、血小板计数、淋巴细胞计数)、神经元烯醇化酶(NSE)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)。下载肿瘤基因组图谱(The Cancer Genome Atlas, TCGA)数据库中的肺鳞癌、肺腺癌数据,分析TFF3表达水平与化疗疗效的关系。结果在非小细胞肺癌组中,肺腺癌和肺鳞癌患者化疗前血清TFF3水平均高于健康对照组,差异有统计学意义(P<0.05)。在血小板计数≥中位数的非小细胞肺癌患者血清中,TFF3的水平高于血小板计数<中位数组的非小细胞肺癌患者(P<0.05)。血清TFF3水平诊断非小细胞肺癌、肺腺癌、肺鳞癌的ROC曲线下面积(AUC)分别为0.73[95%CI(0.62,0.83)]、0.69[95%CI(0.56,0.82)]、0.77[95%CI(0.66,0.89)],约登指数分别为0.45、0.37、0.55,截断值分别为1109.37 pg/mL、1109.37 pg/mL、1110.61 pg/mL。在接受化疗的非小细胞肺癌患者中,化疗后血清TFF3水平显著低于化疗前,差异有统计学意义(P<0.05)。亚组分析显示:肺腺癌患者化疗后血清TFF3水平显著低于化疗前,差异有统计学意义(P<0.05),而肺鳞癌患者化疗前后血清TFF3水平无明显变化。通过分析TCGA数据库中非小细胞肺癌患者Objective To investigate the role of trefoil factor 3(TFF3) in the diagnosis and evaluation of chemotherapy efficacy of non-small cell lung cancer(NSCLC), and to provide a new tumor marker for the diagnosis and treatment evaluation of NSCLC.Methods From June 20, 2020 to June 6, 2021, 84 patients diagnosed with NSCLC [38 cases of lung squamous cell carcinoma(LUSC) and 46 cases of lung adenocarcinoma(LUAD)] were allocated into the NSCLC group in the First Affiliated Hospital of Anhui Medical University, and 21 health checkup confirmed healthy individuals were selected as the control group. The NSCLC patients who only received pemetrexed(LUAD) or paclitaxel(LUSC)+platinum for chemotherapy for two cycles were followed up as the chemotherapy group. In NSCLC patients, the serum TFF3 levels were detected in the initial diagnosis and the end of two cycles ofchemotherapy by using the enzyme linked immunosorbent assay( ELISA),respectively. In the control group,the serum TFF3 levels were detected in the first day of health checkup. The peripheral blood laboratory indexes in NSCLC patients,including neutrophil count,platelet count,lymphocyte count,neuron specific enolase( NSE),carcinoembryonic antigen( CEA) and cytokeratin 19 fragment( CYFRA21-1),were collected at the first diagnosis. The LUSC and LUAD data in the Cancer Genome Atlas( TCGA) database was downloaded to analyze the association between TFF3 expression level and chemotherapy efficacy. Results In the NSCLC group,the levels of TFF3 in patients with LUAD and LUSC were both significantly higher than those in the healthy control group before chemotherapy( P <0. 05). The level of TFF3 in NSCLC patients with platelet count ≥ median level was higher than that in patients with platelet count < median level( P < 0. 05). The area under the receiver operating characteristic( ROC) curve( AUC) of serum TFF3 level in the diagnosis of NSCLC,LUAD and LUSC were 0. 73[95% CI( 0. 62,0. 83) ],0. 69[95% CI( 0. 56,0. 82) ],and 0. 77 [95% CI( 0. 66,0. 89) ],and the Youden index for NS

关 键 词：非小细胞肺癌 TFF3 诊断 化疗疗效评估 

分 类 号：R734.2[医药卫生—肿瘤]