VHL表达对非小细胞肺癌铂类化疗不良反应及远期预后的影响  

Effect of VHL expression on adverse reactions and long-term prognosis of platinum-based chemotherapy in non-small cell lung cancer

作　　者：曹晔鋆 张启颖[1] 洪暄[1] 朱慧蓉[2] Cao Yejun;Zhang Qinyin;Hong Xuan;Zhu Huirong(Department of Thoracic Surgery,Dongfang Hospital Affiliated to Tongji University,Shanghai 200120,China;Department of General Practice,Tangqiao Community Health Service Center,Pudong New District,Shanghai 200127,China)

机构地区：[1]同济大学附属东方医院胸外科,上海200120 [2]上海市浦东新区塘桥社区卫生服务中心全科医学科,上海200127

出　　处：《中华转移性肿瘤杂志》2024年第5期428-434,共7页Chinese Journal of Metastatic Cancer

基　　金：上海市浦东新区卫生系统社区学科带头人培养计划(PWRsd2019-2);上海市浦东新区卫生健康委员会优秀青年医学人才培养项目(PWRq2023-33)。

摘　　要：目的探讨VHL表达水平与非小细胞肺癌(NSCLC)患者化疗不良反应及临床预后的关系。方法对2018—2021年间接受肺癌根治术并经病理确诊的110例NSCLC患者病理样本进行免疫组织化学染色以评估VHL表达水平。进一步收集患者临床数据,并随访预后结果。χ2检验评估VHL表达水平与血液不良反应关联性。VHL表达水平对NSCLC化疗预后影响采用Kaplan-Meier曲线评估,并采用Cox模型及R包森林图模型进行验证。结果NSCLC病理组织中VHL表达水平与粒细胞减少显著相关(P<0.05),VHL无表达或低表达是NSCLC术后患者接受铂类化疗后粒细胞减少的危险因素(OR=0.264,95%CI为0.085~0.818,P=0.021)。VHL表达水平与患者总生存时间相关(P=0.007),而与无瘤生存时间无关,VHL高表达是预后不良因素(HR=4.219,95%CI为1.75~10.174,P=0.001)。结论VHL表达水平与NSCLC化疗粒细胞减少有关,并且跟NSCLC患者化疗后总生存时间显著相关,其可能作为预测NSCLC患者化疗远期预后潜在遗传标志。Objective To explore the relationship between VHL expression level and chemotherapy adverse reactions and clinical prognosis of patients with non-small cell lung cancer(NSCLC).Methods Immunohistochemical staining for the expression level of VHL was performed on pathological samples of 110 NSCLC patients who underwent radical resection and were pathologically confirmed during 2018 to 2021.Clinical data of patients were collected,and patient prognosis was followed up.The association between VHL expression level and blood adverse reactions was evaluated using chi-square tests.The impact of VHL expression level on the prognosis of NSCLC chemotherapy was assessed using Kaplan-Meier curve analysis,and validated using Cox risk regression model and R package forest plot model.Results This study showed a significant correlation between the expression level of VHL in the pathological tissues of NSCLC and granulocyte reduction(P<0.05).Further multivariate analysis revealed that none or low expression of VHL was a risk factor for granulocyte reduction in NSCLC patients after platinum-based chemotherapy(OR=0.264,95%CI:0.085-0.818,P=0.021).The expression level of VHL was associated with overall survival time(P=0.007),but not with disease-free survival time.Cox survival analysis showed that high expression of VHL in pathological tissue was a poor prognostic factor for patients(HR=4.219,95%CI:1.75-10.174,P=0.001).Conclusion sThe expression level of VHL is associated with chemotherapy granulocyte reduction in NSCLC and significantly correlated with overall survival time after chemotherapy in NSCLC patients.It may serve as a potential genetic marker for predicting the long-term prognosis of NSCLC patients undergoing chemotherapy.

关 键 词：非小细胞肺癌 VHL表达水平 血液不良反应 预后 

分 类 号：R734.2[医药卫生—肿瘤]