血浆cf DNA、CYFRA21-1水平与晚期非鳞非小细胞肺癌患者预后的关系  

The Relationship between Plasma cf DNA,CYFRA21-1 Levels and Prognosis of Patients with Advanced Non-squamous NSCLC

作　　者：秦学金 康慢慢 朱正春 刘婧婧 张迪 韩柯 QIN Xuejin;KANG Manman;ZHU Zhengchun;LIU Jingjing;ZHANG Di;HAN Ke(Department of Oncology,Fuyang Hospital Affiliated to Anhui Medical University,Fuyang,Anhui 236000,China)

机构地区：[1]安徽医科大学附属阜阳医院肿瘤科,安徽236000

出　　处：《转化医学杂志》2025年第3期11-15,共5页Translational Medicine Journal

基　　金：安徽省高等学校科学研究项目(2023AH050676)。

摘　　要：目的探究血浆循环游离DNA(cf DNA)、细胞角蛋白19片段抗原(CYFRA21-1)水平与晚期非鳞非小细胞肺癌(NSCLC)患者预后的关系。方法选取2019年1月至2021年12月安徽医科大学附属阜阳医院肿瘤科收治的116例晚期非鳞NSCLC患者为研究对象,均接受贝伐珠单抗联合紫杉醇卡铂(TC)方案化疗,随访2年后,根据预后将其分为生存组(48例)和死亡组(68例)。化疗前检测所有患者血浆cf DNA、CYFRA21-1水平。采用Spearman分析血浆cf DNA、CYFRA21-1水平与患者预后的相关性;采用单因素及多因素分析患者预后影响因素;采用受试者工作特征(ROC)曲线分析血浆cf DNA、CYFRA21-1水平对患者预后的预测价值。结果死亡组淋巴结转移比例高于生存组(P<0.05);死亡组血浆cf DNA、CYFRA21-1水平均高于生存组(P均<0.05);Spearman分析显示,血浆cf DNA、CYFRA21-1水平与晚期非鳞NSCLC患者预后均呈正相关(P均<0.05);Logistic回归分析显示,淋巴结转移(OR=6.719,95%CI:1.412~31.982)、血浆cf DNA(OR=1.861,95%CI:1.300~2.664)及CYFRA21-1(OR=1.564,95%CI:1.145~2.135)水平为影响晚期非鳞NSCLC患者预后的相关因素(P均<0.05);ROC曲线显示,血浆cf DNA、CYFRA21-1水平单独预测晚期非鳞NSCLC患者预后的曲线下面积(AUC)分别为0.857、0.842,二者联合预测的AUC(0.926)高于单独预测(P<0.05)。结论血浆cf DNA、CYFRA21-1水平与晚期非鳞NSCLC患者预后密切相关,二者对患者预后具有一定预测价值,且联合预测价值更高。Objective To explore the relationship between plasma circulating free DNA and cytokeratin 19 fragment antigen(CYFRA21-1)levels and the prognosis of patients with advanced cell lung cancer(NSCLC).Methods A total of 116 patients with advanced NSCLC in the Department of Oncology,Fuyang Hospital Affiliated to Anhui Medical University from January 2019 to December 2021 were selected as the research objects.All patients received chemotherapy with the bevacizumab combined with paclitaxel and carboplatin(TC)regimen.After 2 years of follow-up,they were divided into the survival group(n=48)and the death group(n=68)according to the prognosis.Plasma cf DNA and CYFRA21-1 levels were detected before chemotherapy.The correlation between plasma cf DNA and CYFRA21-1 levels and the prognosis of patients was analyzed by Spearman correlation analysis.The influencing factors of prognosis were analyzed by univariate and multivariate analyses.The predictive value of plasma cf DNA and CYFRA21-1 levels for the prognosis of patients was analyzed by the receiver operating characteristic(ROC)curve.Results The proportion of lymph node metastasis in the death group was higher than that in the survival group(P<0.05).The levels of plasma cf DNA and CYFRA21-1 in the death group were also higher than those in the survival group(P<0.05).Spearman correlation analysis showed that plasma cf DNA and CYFRA21-1 levels were positively correlated with the prognosis of patients with advanced NSCLC(P<0.05).Logistic regression analysis showed that lymph node metastasis(OR=6.719,95%CI:1.412-31.982),plasma cf DNA(OR=1.861,95%CI:1.300-2.664)and CYFRA21-1(OR=1.564,95%CI:1.145-2.135)levels were related to the prognosis of patients with advanced non-squamous NSCLC(P<0.05).ROC analysis showed that the area under the curve(AUC)of plasma cf DNA and CYFRA21-1 levels alone for predicting the prognosis of patients with advanced nonsquamous NSCLC were 0.857,0.842,respectively,and the AUC(0.926)of the combination was higher than that of the individual predictors(P<0.05).C

关 键 词：非鳞非小细胞肺癌 晚期 游离DNA 细胞角蛋白19片段抗原21-1 

分 类 号：R734.2[医药卫生—肿瘤]