摘要
目的探讨巨噬细胞抑制因子1(MIC-1)在非小细胞肺癌(NSCLC)诊断及靶向治疗疗效预测中的应用价值。方法选取2013年1月-2015年1月该院收治的Ⅲb期、Ⅳ期NSCLC患者94例、肺部良性疾病78例及体检健康者70例分别作为NSCLC组、良性组及对照组,采用双抗体夹心酶联免疫吸附实验检测MIC-1水平。NSCLC组均接受靶向治疗,单因素和多因素Cox回归分析NSCLC组中位生存时间的影响因素。结果 NSCLC组血清MIC-1水平高于良性组和对照组,且良性组高于对照组(P<0.05);NSCLC组不同TNM分期的MIC-1水平比较,差异有统计学意义(P<0.05),不同年龄、性别、靶向治疗方案及表皮生长因子受体(EGFR)基因突变的比较,差异无统计学意义(P>0.05)。NSCLC组均接受靶向治疗,治疗3和5个月MIC-1水平均较治疗前和治疗1个月降低(P<0.05);治疗前,治疗1、3及5个月组间比较,差异有统计学意义(P<0.05);治疗5个月时,治疗有效率32.98%;Kaplan-Meier法估计生存率,NSCLC组中位生存时间(MST)为17.9个月。以1 390 pg/ml为临界值,将其分为MIC-1≤1 390 pg/ml组(59例)和MIC-1>1 390 pg/ml组(35例),两组3年生存率分别为33.90%和14.29%(P<0.05)。Cox回归分析显示,TNM分期、EGFR基因突变及MIC-1水平是影响NSCLC组MST的危险因素。结论血清MIC-1水平与Ⅲb期、Ⅳ期NSCLC组TNM分期和靶向治疗效果有关,可用于预测患者预后。
Objective To investigate the clinical significance of macrophage inhibitory cytokine-1（MIC-1） in non-small cell lung cancer（NSCLC）. Methods A total of 94 patients with stage Ⅲ band stage Ⅳ NSCLC, 78 patients with benign pulmonary diseases, and 70 healthy subjects admitted to the hospital from January 2013 to January 2015 were included in this study. The MIC-1 level was detected by ELISA. Patients with NSCLC received targeted therapy. Results Serum level of MIC-1 was higher significantly in the NSCLC group compared with benign group and control group, while MIC-1 was upregulated in the benign group compared with control group（P 〈 0.05）. MIC-1 was closely associated with TNM stages（P 〈 0.05） while no significant relationship was observed among age, gender, targeted therapy and EGFR gene mutation in NSCLCgroup（P 〉 0.05）. MIC-1 levels in patients receiving treatments for 3 months and 5 months decreased compared with those before treatment and receiving treatment for 1 month（P 〈 0.05）. There were significant differences in MIC-1 levels between groups at 3 months, 5 months and 7 months prior to treatment（P 〈 0.05）. Treatment effective rate was 32.98% with 5 months of treatments. The treatment effective rate in patients with mutation was higher than that of wild type（64.86% vs 12.28%, P 〈 0.05）. The MIC-1 level in treatment group with positive response was significantly lower than that in group with negative response（P 〈 0.05）. ROC analysis showed that the median survival time（MST） was 17.9 months. With 1,390 pg/ml as the cut-off value, patients were divided into the low group（MIC-1 ≤ 1,390 pg/ml group, n = 59） and high group（MIC-1 〉 1,390 pg/ml group, n = 35）. Patients in high group experienced significant higher 3-year survival rate compared to low group（33.90% vs 14.29%, P 〈 0.05）. Cox analysis showed that TNM stage, EGFR gene mutation and MIC-1 level were independent risk factors for MST of patients with NSCLC. Conclusion The serum MIC-1 level is correlated to TNM stages, and the effectiveness of targeted therapy, and MIC-1 may be a prognostic biomarker in patients with stage Ⅲ b-stage Ⅳ NSCLC
作者
辛影
朱晶
柳影
Ying Xin;Jing Zhu;Ying Liu(Department of the First Tumor Internal Medicine,Tumor Hospital of Jilin Province,Changchun,jilin 130021,China)
出处
《中国现代医学杂志》
CAS
2018年第18期39-44,共6页
China Journal of Modern Medicine
关键词
非小细胞肺癌
巨噬细胞抑制因子1
检测
靶向治疗
临床疗效
中位生存时间
non-small cell lung cancer
macrophage inhibitory cytokine-1
detection
targeted therapy
clinical efficacy
median survival time
