血清趋化因子水平与中晚期NSCLC患者近期预后不良的关系研究  

Exploration of the relationship between serum chemokine levels and poor short-term prognosis in patients with advanced NSCLC

作　　者：李景艳 牛红蕊[1] LI Jingyan;NIU Hongrui(Department of Oncology,First Affiliated Hospital of Xinxiang Medical College,Xinxiang,Henan 453001,China)

机构地区：[1]新乡医学院第一附属医院肿瘤科,河南新乡453001

出　　处：《现代医药卫生》2024年第23期4031-4035,4040,共6页Journal of Modern Medicine & Health

摘　　要：目的探讨血清趋化因子水平与中晚期非小细胞肺癌(NSCLC)患者近期预后不良的关系。方法选取2019年8月至2023年9月该院收治的中晚期NSCLC患者257例作为研究对象,检测血清CX3趋化因子配体1(CX3CL1)、CC趋化因子配体5(CCL5)、CCL20水平,比较不同病理特征患者血清CX3CL1、CCL5、CCL20水平的差异。257例患者在治疗过程中转院5例,最终纳入252例。根据近期预后情况分为预后不良组(65例)和预后良好组(187例)。比较2组患者一般资料,以及血清CX3CL1、CCL5、CCL20水平的差异。采用logistic回归模型分析中患者近期预后不良的危险因素,绘制受试者工作特征(ROC)曲线分析血清CX3CL1、CCL5、CCL20单项及联合检测对中晚期NSCLC患者近期预后不良的预测价值。结果腺癌、TNM分期Ⅳ期患者血清CX3CL1、CCL5、CCL20水平均高于鳞癌、TNM分期Ⅱb~Ⅲ期患者,差异均有统计学意义(P<0.05);252例患者近期预后不良发生率为25.79%(65/252);预后不良组患者血清CX3CL1、CCL5、CCL20水平,以及TNM分期Ⅳ期占比均明显高于预后良好组,差异均有统计学意义(P<0.05);血清CX3CL1、CCL5、CCL20水平升高,研究TNM分期Ⅳ期均是中晚期NSCLC患者近期预后不良的危险因素(P<0.05);血清CX3CL1、CCL5、CCL20联合检测预测中晚期NSCLC患者近期预后不良的灵敏度、ROC曲线下面积分别为93.85%、0.916,均高于单项检测,差异均有统计学意义(P<0.05);联合检测预测中晚期NSCLC患者近期预后不良的特异度与单项检测基本一致。结论血清CX3CL1、CCL5、CCL20水平与中晚期NSCLC患者病理类型和TNM分期密切相关,且均是患者近期预后不良的危险因素,对近期预后具有预测价值,三者联合检测能进一步提高预测价值。Objective To explore the relationship between serum levels of chemokines and poor short-term prognosis in patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 257 patients with advanced NSCLC admitted to our hospital from August 2019 to September 2023 were selected as the study subjects.The serum levels of CX3 chemokine ligand 1(CX3CL1),CC chemokine ligand 5(CCL5),and CCL20 were measured.The differences in serum levels of CX3CL1,CCL5,and CCL20 among patients with different pathological characteristics were compared.During the course of treatment,5 patients were transferred to other hospitals,leaving a final inclusion of 252 patients.Based on their recent prognosis,the patients were divided into a poor prognosis group(n=65)and a good prognosis group(n=187).The general information and serum levels of CX3CL1,CCL5,and CCL20 were compared between the two groups.Logistic regression models were used to analyze the risk factors for poor recent prognosis in these patients.Receiver operating characteristic(ROC)curves were plotted to assess the predictive value of individual and combined detection of serum CX3CL1,CCL5,and CCL20 for poor recent prognosis in patients with advanced NSCLC.Results The serum levels of CX3CL1,CCL5 and CCL20 in patients with adenocarcinoma and TNM stageⅣwere higher than those in patients with squamous cell carcinoma and TNM stageⅡb-Ⅲ,and the differences were statistically significant(P<0.05).The incidence of poor short-term prognosis in 252 patients was 25.79%(65/252).The serum levels of CX3CL1,CCL5,CCL20 and the proportion of TNM stageⅣin the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).Elevated serum levels of CX3CL1,CCL5,CCL20 and TNM stageⅣwere all risk factors for poor short-term prognosis in patients with advanced NSCLC(P<0.05).The sensitivity and area under ROC curve of the combination of serum CX3CL1,CCL5 and CCL20 in predicting poor prognosis in mid to late stage NSCLC pat

关 键 词：趋化因子 非小细胞肺癌 预后 关系分析 

分 类 号：R734.2[医药卫生—肿瘤]