摘要
目的探讨非小细胞肺癌(NSCLC)患者血清转录因子性别决定区Y框蛋白11(SOX11)、胃泌素释放肽前体(ProGRP)、去整合素金属蛋白酶12(ADAM12)表达与临床病理特征及预后的关系。方法选取2020年3月至2022年3月本院收治的符合手术治疗指征的134例NSCLC患者及134例无肺部疾病的体检者为研究对象,分别纳入NSCLC组和健康组;其中31例患者随访期间发生局部复发或远处转移,纳入复发转移组,其余103例患者术后病情稳定,纳入无复发转移组。采用ELISA法检测血清SOX11、ProGRP、ADAM12水平;采用多因素Logistic回归分析NSCLC患者术后局部复发或远处转移的影响因素;采用ROC曲线评估SOX11、ProGRP、ADAM12对NSCLC患者术后局部复发或远处转移的预测价值。结果NSCLC组血清SOX11、ProGRP和ADAM12水平较健康组显著升高(P<0.05)。SOX11、ProGRP和ADAM12表达与TNM分期有关(P<0.05)。对于血清SOX11、ProGRP、ADAM12水平,ⅢA期NSCLC患者高于Ⅰ~Ⅱ期NSCLC患者,其中接受辅助化疗的Ⅰ~Ⅱ期NSCLC患者低于未接受辅助化疗的Ⅰ~Ⅱ期NSCLC患者(P<0.05)。复发转移组患者处于ⅢA期人数占比高于无复发转移组患者,复发转移组术后血清SOX11、ProGRP、ADAM12水平显著高于术前(P<0.05),无复发转移组术后血清SOX11、ProGRP、ADAM12水平低于术前(P<0.05);与无复发转移组比较,复发转移组术后血清SOX11、ProGRP、ADAM12水平显著升高(P<0.05),ⅢA期及SOX11、ProGRP、ADAM12均为NSCLC患者术后局部复发或远处转移的危险因素(P<0.05)。SOX11、ProGRP、ADAM12联合预测NSCLC患者术后局部复发或远处转移的AUC为0.953(95%CI:0.916~0.989),优于SOX11(Z=2.532,P<0.001)、ProGRP(Z=3.476,P<0.001)、ADAM12(Z=2.680,P<0.001)单一预测的AUC。结论NSCLC患者血清SOX11、ProGRP、ADAM12水平升高,三者与TNM分期密切相关,三者联合预测NSCLC患者术后局部复发或远处转移的价值较高。
Objective To investigate the relationship between serum expressions of sex-determining region Y-box 11(SOX11),progastrin-releasing peptide(ProGRP),and a disintegrin and metalloproteinase 12(ADAM12)with clinicopathological features and prognosis in patients with non-small cell lung cancer(NSCLC).Methods A total of 134 NSCLC patients who met surgical treatment criteria and 134 healthy individuals without lung diseases admitted to our hospital between March 2020 and March 2022 were selected as research subjects,and divided into the NSCLC group and the healthy group,respectively.Among the NSCLC patients,31 developed local recurrence or distant metastasis during follow-up(recurrence/metastasis group),and the remaining 103 had stable conditions after surgery(non-recurrence/metastasis group).Serum levels of SOX11,ProGRP,and ADAM12 were detected by enzyme-linked immunosorbent assay(ELISA).Multivariate Logistic regression analysis was used to identify influencing factors for postoperative local recurrence or distant metastasis in NSCLC patients.The receiver operating characteristic(ROC)curve was employed to evaluate the predictive value of SOX11,ProGRP,and ADAM12 for postoperative recurrence or metastasis.Results Serum levels of SOX11,ProGRP,and ADAM12 in the NSCLC group were significantly higher than those in the healthy group(all P<0.05).The expressions of SOX11,ProGRP,and ADAM12 were correlated with TNM staging(all P<0.05).Serum levels of SOX11,ProGRP,and ADAM12 in stageⅢA NSCLC patients were higher than those in stageⅠ~Ⅱpatients;among stageⅠ~Ⅱpatients,those who received adjuvant chemotherapy had lower levels than those who did not(all P<0.05).The proportion of stageⅢA patients in the recurrence/metastasis group was higher than that in the non-recurrence/metastasis group.Postoperative serum levels of SOX11,ProGRP,and ADAM12 in the recurrence/metastasis group were significantly higher than preoperative levels(all P<0.05),while those in the non-recurrence/metastasis group were lower than preoperative levels(all P<0.05).Compared with the non-recurrence/metastasis group,postoperative serum levels of SOX11,ProGRP,and ADAM12 in the recurrence/metastasis group were significantly elevated(all P<0.05).StageⅢA,SOX11,ProGRP,and ADAM12 were all risk factors for postoperative local recurrence or distant metastasis in NSCLC patients(all P<0.05).The area under the ROC curve(AUC)of the combined detection of SOX11,ProGRP,and ADAM12 for predicting postoperative recurrence or metastasis was 0.953(95%CI:0.916~0.989),which was superior to the AUC of single marker prediction(SOX11:Z=2.532,P<0.001;ProGRP:Z=3.476,P<0.001;ADAM12:Z=2.680,P<0.001).Conclusion Serum SOX11,ProGRP,and ADAM12 are elevated in NSCLC patients,and they are closely related to TNM staging.The combined detection of these three markers has high value in predicting postoperative local recurrence or distant metastasis in NSCLC patients.
作者
徐海亮
申思
杨泽西
XU Hailiang;SHEN Si;YANG Zexi(Department of Respiratory and Critical Care Medicine,Baoding First Central Hospital,Baoding,Hebei 071000,China)
出处
《临床肺科杂志》
2026年第3期417-423,共7页
Journal of Clinical Pulmonary Medicine
基金
河北省2025年度医学科学研究课题(20251437)。
