非小细胞肺癌患者治疗前后血浆Apelin水平变化  

The change of plasma apelin in patients with non-small cell lung cancer before and after therapy

作　　者：张明 黄新宇 汪建英 陈欣 徐雁 余晓婷 尹帅 高天巍 ZHANG Ming;HUANG Xinyu;WANG Jianying(Department of Critical Care Medicine,Affiliated Hangzhou Cancer Hospital,Zhejiang University School of Medicine,Hangzhou 310002,China)

机构地区：[1]浙江大学医学院附属杭州市肿瘤医院重症医学,浙江杭州310002 [2]浙江大学医学院附属杭州市肿瘤医院肿瘤内科,浙江杭州310002

出　　处：《全科医学临床与教育》2022年第11期987-990,共4页Clinical Education of General Practice

基　　金：杭州市科技计划项目(20180533B65)。

摘　　要：目的观察非小细胞肺癌患者血浆Apelin水平治疗前后的变化并探讨其临床意义。方法入选21例早期非小细胞肺癌原发肿瘤未转移患者(G1组),23例非小细胞肺癌伴转移患者(G2组),20例健康志愿组(G3组)。G1组、G2组分别在肿瘤治疗前(T1)、肿瘤治疗后1周(T2)及肿瘤治疗后1个月(T3)三个时间点经肘静脉途径采血。G3组同期静脉采血。采用酶联免疫吸附法测定血浆Apelin水平,并监测淋巴细胞亚群水平以评估患者免疫状态。结果在T1、T2时刻,G1组、G2组血浆Apelin水平高于G3组,差异有统计学意义(t分别=3.99、4.37;3.03、3.91,P均<0.05),且T1时G2组血浆Apelin水平高于G1组(t=1.68,P<0.05)。在T3时刻,G1组血浆Apelin水平与G2组、G3组比较,差异无统计学意义(t分别=1.01、1.09,P均>0.05),G2组血浆Apelin水平高于G3组,差异有统计学意义(t=1.96,P<0.05)。在T1时刻,G1组和G2组CD3、CD3^(+)CD4^(+)、CD3^(+)CD8+及淋巴细胞总数均低于G3组,差异有统计学意义(t分别=3.78、2.19、2.91、3.14;4.62、3.46、3.25、3.56,P均<0.05);G1组和G2组比较,差异无统计学意义(t分别=1.02、1.16、1.25、1.27,P均>0.05);而G1组和G2组肿瘤标记物(CYFRA 21-1、癌胚抗原及神经元烯醇化酶)水平明显高于G3组,差异有统计学意义(t分别=3.84、3.65、3.49;3.93、4.08、4.25,P均<0.05),G1组和G2组比较,差异均无统计学意义(t分别=1.32、1.21、1.03,P均>0.05)。治疗前非小细胞肺癌患者血浆Apelin水平与CD3、CD3^(+)CD4^(+)计数呈负相关(r分别=-0.53、-0.47,P均<0.05)。结论非小细胞肺癌患者血浆Apelin水平高,转移患者升高明显,经治疗后能降低;血浆Apelin水平变化与患者免疫功能状态有关。Apelin可能参与非小细胞肺癌发生、转移过程。Objective To observe the change of plasma apelin in patients of non-small cell lung cancer before and after therapy and explore its potential clinical significance.Methods A total of 21 patients who were diagnosed as adenocarcinoma in situ of non-small cell lung cancer(group G1),23 patients who were diagnosed as metastatic carcinoma of non-small cell lung cancer(group G2)and 20 healthy volunteers(group G3)were enrolled in the study.The plasma apelin was detected before therapy(T1),a week after therapy(T2)and a month after therapy(T3)in group G1 and group G2.The T lymphocyte subgroup and immunoglobulin state in peripheral blood in patients of non-small cell lung cancer were detected at meanwhile.Results At T1 and T2,the plasma apelin level in group G1 and group G2 was higher than that in G3 group(t=3.99,4.37,3.03,3.91,P<0.05),and the plasma apelin level in group G2 was higher than that in group G1 at T1(t=1.68,P<0.05).At T3,there was no statistically significant difference between group G1 and group G2,group G3(t=1.01,1.09,P>0.05),group G2 was higher than group G3 in plasma Apelin level(t=1.96,P<0.05).At T1,the total number of CD3,CD3^(+)CD4^(+),CD3^(+)CD8+and lymphocytes in group G1 and group G2 were lower than those in group G3(t=3.78,2.19,2.91,3.14,4.62,3.46,3.25,3.56,P<0.05),but there was no significant difference between group G1 and group G2(t=1.02,1.16,1.25,1.27,P>0.05).The levels of tumor markers(CYFRA 21-1,carcinoembryonic antigen and neuron enolase)in group G1 and group G2 were significantly higher than those in group G3(t=3.84,3.65,3.49,3.93,4.08,4.25,P<0.05),and there was no significant difference between group G1 and group G2(t=1.32,1.21,1.03,P>0.05).There was a negative correlation between the plasma apelin level and the counts of CD3 and CD3^(+)CD4^(+)in NSCLC patients before treatment(r=-0.53,-0.47,P<0.05).Conclusion The level of plasma apelin was elevated in the patients of non-small cell lung cancer,and increased significantly in metastatic carcinoma,and decreased significantly after therapy.The

关 键 词：非小细胞肺癌 APELIN 

分 类 号：R734.2[医药卫生—肿瘤]