非小细胞肺癌患者的血清sMICA水平及临床意义  

Clinical significance of soluble MICA level in the serum of patients with non-small cell lung cancer

作　　者：肖一文 殷小伟[1] 卢绪章[1] 蒋华[1] XIAO Yiwen;YIN Xiaowei;LU Xuzhang;JIANG Hua(Cancer Center, Changzhou No. 2 Hospital Affiliated to Nanjing Medical University, Changzhou 213000,China)

机构地区：[1]南京医科大学附属常州二院肿瘤中心,江苏常州213003

出　　处：《临床肿瘤学杂志》2022年第4期339-343,共5页Chinese Clinical Oncology

基　　金：常州市卫生局重大科技项目(ZD201311)。

摘　　要：目的探讨非小细胞肺癌(NSCLC)患者血清中可溶性MHCⅠ类链相关分子A(sMICA)的水平及临床意义。方法采用酶联免疫吸附法检测本院2013年1月至2017年12月的65例初诊NSCLC患者和50例体检健康者以及40例化疗后可评价疗效NSCLC患者的血清sMICA水平,实时定量PCR检测12例手术或支气管镜活检肺癌组织和5例来源于肺大泡患者正常肺组织的MICA水平并分析组织MICA水平与血清sMICA水平的相关性,根据随访数据分析血清sMICA水平与预后的关系。结果NSCLC患者的血清sMICA水平为(127.2±25.7)ng/L,高于体检健康者的(57.2±26.7)ng/L(P<0.05)。25例Ⅰ~Ⅱ期患者的血清sMICA水平为(109.6±25.4)ng/L,低于40例Ⅲ~Ⅳ期患者的(136.2±23.6)ng/L(P<0.05);38例肺鳞癌患者的血清sMICA水平为(128.8±23.8)ng/L,与27例肺腺癌患者的(135.2±22.9)ng/L相比差异无统计学意义(P>0.05)。40例NSCLC患者通过化疗后,33例化疗有效者的血清sMICA水平为(72.5±29.7)ng/L,低于化疗前的(139.2±24.9)ng/L(P<0.05),而7例化疗无效者的血清sMICA水平为(153.2±35.2)ng/L,较化疗前(131.2±16.7)ng/L的差异无统计学意义(P>0.05)。NSCLC患者的血清sMICA水平与肺癌组织的MICA水平无关(r=0.131,P=0.685)。血清sMICA低水平组的中位总生存期为1185天,优于高水平组的984天(P<0.05)。结论NSCLC患者的血清sMICA水平升高且与患者的治疗反应和预后有关,但与肺癌组织的基因表达无关。监测患者外周血清中sMICA水平有助于NSCLC临床诊断和疗效评估。Objective To investigate the level and clinical significance of soluble MHC class I chain-related molecule A(sMICA)in serum of patients with non-small cell lung cancer(NSCLC).Methods The serum sMICA levels of 65 newly diagnosed NSCLC patients,50 healthy people and 40 NSCLC patients with evaluable curative effect after chemotherapy were detected by enzyme-linked immunosorbent assay from January 2013 to December 2017.Real-time quantitative PCR was used to detect MICA level in 12 cases of lung cancer tissues from surgery or bronchoscopic biopsy and 5 cases of normal lung tissues from patients with pulmonary bullae.Correlation between tissue level of MICA and serum level of sMICA was investigated.The relationship between serum sMICA level and prognosis was analyzed according to the follow-up data.Results The serum sMICA level in patients with NSCLC was(127.2±25.7)ng/L,higher than(57.2±26.7)ng/L in healthy subjects(P<0.05).The serum sMICA level of 25 patients with stageⅠ-Ⅱwas(109.6±25.4)ng/L,lower than(136.2±23.6)ng/L of 40 patients with stageⅢ-Ⅳ(P<0.05).The serum sMICA level of 38 patients with lung squamous cell carcinoma was(128.8±23.8)ng/L,similar with(135.2±22.9)ng/L of 27 patients with lung adenocarcinoma(P>0.05).After chemotherapy in 40 patients with NSCLC,the serum sMICA level of 33 patients with effective chemotherapy was(72.5±29.7)ng/L,lower than(139.2±24.9)ng/L before chemotherapy(P<0.05),while the serum sMICA level of 7 patients with ineffective chemotherapy was(153.2±35.2)ng/L,similar with(131.2±16.7)ng/L before chemotherapy(P>0.05).The serum sMICA level of patients with NSCLC was not related to the MICA level of lung cancer tissues(r=0.131,P=0.685).The median overall survival of low-level serum sMICA group was 1185 days,better than 984 days of high-level group(P<0.05).Conclusion The serum level of sMICA in patients with NSCLC increased,which was related to the treatment response and prognosis,but not to the gene expression of lung cancer.Monitoring the sMICA level in patients'peripheral

关 键 词：非小细胞肺癌 可溶性MHCⅠ类链相关分子A 临床意义 预后 

分 类 号：R734.2[医药卫生—肿瘤]