DLL3表达和血清NSE与小细胞肺癌预后的相关性分析  

Predictive value of DLL3 and pre-treatment serum NSE in evaluating the prognosis of patients with small cell lung carcinoma

作　　者：刘丹丹 张孝飞[2] 王锦 黄慧华 程雪松 LIU Dan-dan;ZHANG Xiao-fei;WHANG Jin;HUANG Hui-hua;CHENG Xue-song(Anhui NO.2 Provincial People′s Hospital,Hefei,Anhui 230041,China;Department of Respiratory and Intensive Care Unit,Bozhou People′s Hospital,Bozhou,Anhui 236800,China)

机构地区：[1]安徽省第二人民医院呼吸与危重症医学科,安徽合肥230041 [2]亳州市人民医院呼吸与危重症医学科,安徽亳州236800

出　　处：《临床肺科杂志》2022年第12期1793-1797,1803,共6页Journal of Clinical Pulmonary Medicine

摘　　要：目的评估Delta-like protein 3(简称DLL3)、血清神经元特异性烯醇化酶(serum neuron-specifc enolase,NSE)和其他潜在预后因素在晚期小细胞肺癌(small cell lung cancer,SCLC)患者预后中的价值。方法选取确诊为SCLC的患者,采用免疫组化方法检测DLL3在SCLC肿瘤组织中的表达情况,根据DLL3表达情况将患者分为高表达组(DLL3-high)和低表达组(DLL3-low)。Kaplan-Meier和Cox多因素分析探究DLL3表达及血清NSE对晚期SCLC患者无进展生存期(progression-free survival,PFS)及总生存期(overall survival,OS)的影响。结果DLL3-low组的中值PFS为6.6个月(区间:5.6~7.6),DLL3-high组为4.2个月(区间:3.1~5.3),差异具有统计学意义(P=0.009)。NSE<35ng/mL组的PFS和OS均长于NSE≥35ng/mL组(P<0.05)。低DLL3表达和血清NSE<35ng/mL的患者呈现出最佳的生存期。Cox Hazard多因素分析显示,高DLL3表达和肿瘤直径>5cm是PFS的独立危险因素,NSE<35ng/mL、年龄<70岁和Ki67在肿瘤组织中的阳性细胞数≤60%是OS的独立预后因素,分期和化疗是PFS和OS的独立预后因素(P<0.05)。结论联合DLL3在肿瘤组织中的表达与治疗前血清NSE,有助于预测晚期SCLC患者的预后。Objective To evaluate the value of DLL3,serum NSE and other potential prognostic factors in patients with advanced small cell lung cancer(SCLC).Methods Patients with definite diagnosis of SCLC were selected and the expression of DLL3 in paraffin-embedded tumor tissues of SCLC was detected by immunohistochemical method.According to the expression of DLL3,they were divided into the high expression group(DLL3-high)and the low expression group(DLL3-low).Kaplan-meier and Cox multivariate analysis were conducted to investigate the effect of DLL3 expression and serum NSE on progression-free survival(PFS)and overall survival(OS)of patients with advanced SCLC.Results The median PFS was 6.6 months(rank:5.6~7.6)in the DLL3-low group and 4.2 months(rank:3.1~5.3)in the DLL3-high group,and the difference was statistically significant(P=0.009).PFS and OS in the NSE<35ng/mL group were longer than those in the NSE≥35ng/mL group(P<0.05).Patients with low DLL3 expression and serum NSE<35ng/mL showed the best survival.Cox Hazard multivariate analysis showed that high DLL3 expression and tumor diameter>5cm were independent risk factors for PFS,NSE<35ng/mL,age<70 and the number of Ki67 positive cells in tumor tissue≤60%were independent prognostic factors for OS,and stage and chemotherapy were independent prognostic factors for PFS and OS(P<0.05).Conclusion The expression of DLL3 in tumor tissue and serum NSE before treatment can predict the prognosis of patients with advanced SCLC.

关 键 词：小细胞肺癌 DLL3 NSE 预后 

分 类 号：R734.2[医药卫生—肿瘤]