血清骨桥蛋白水平与非小细胞肺癌预后的相关性

Relationship between Serum Osteopontin Levels and Prognosis in Non-small Cell Lung Cancer

目的研究血清骨桥蛋白(OPN)在非小细胞肺癌中的表达,探讨OPN与非小细胞肺癌预后相关因素之间的关系。方法收集2007年5月-2009年8月宁夏医科大学总医院呼吸内科、心胸外科非小细胞肺癌患者126例,12例患者病例资料不完整失访,随访截至2010年8月31日,共随访完整资料患者114例,采用ELISA法测定非小细胞肺癌患者血清OPN。采用卡方检验、Kaplan-Meier法分析血清OPN与非小细胞肺癌患者生存时间的关系,绘制生存曲线,并用Cox比例风险模型进行影响因素分析。结果 114例患者中血清OPN水平高于中位数组的共60例,平均生存时间(14.33±9.79)个月,血清OPN水平低于中位数组的共54例,平均生存时间(12.71±7.89)个月,差异无统计学意义(P>0.05)。血清OPN水平高于中位数组与低于中位数组患者的1、2、3年的生存率比较差异无统计学意义(P>0.05),而血清OPN水平的高低与临床分期、淋巴结转移及远处转移比较差异有统计学意义(P均<0.05),与性别、年龄、组织学类型无关(P>0.05);临床分期是影响生存时间的危险因素(P<0.05),与血清OPN、性别、年龄、组织学类型无关(P>0.05)。结论非小细胞肺癌患者血清OPN水平的高低与其临床分期、淋巴结转移、远处转移呈正相关,但单一指标不能作为判断非小细胞肺癌患者临床预后转归的依据。

Objective To investigate the expression of serum osteopontin(OPN) in patients with non-small cell lung cancer and to explore the relationship between OPN and prognosis in non-small cell lung cancer.Methods The 126 patients with non-small cell lung cancer were collected from May 2007-Aug 2009,of which 12 cases were followed-up with imperfect information and 114 examples were followed-up with perfect information until August 31,2010.Serum OPN in non-small cell lung cancer was determined using ELISA method.The relation between serum OPN and survival time of patients with non-small cell lung cancer was analyzed by Chisquare test and Kaplan-Meier method.The survivorship curve was drawn and Influence factors analysis was carried-out by COX model.Results Of 114 patients,60 cases showed higher serum OPN level than that of medium group and their average survival time was(14.33 ± 9.79) months.54 cases had lower serum OPN level than medium group with the average survival time(12.71 ± 7.89) months.The difference of both had not statistically difference(P > 0.05).Comparing the serum OPN levels of higher medium group with lower one,the results showed 1,2,3-year survival rate was not statistically difference(P > 0.05).The comparison of serum OPN of high and low level were significantly correlated with clinical stage,lymph node metastasis and distant metastasis.COX regression model showed clinical stage was risk factor of survival time(P < 0.05).Conclusion There were positive correlation between the serum levels of OPN and the clinical stages,lymph transfer,distant transfer in patients with non-small cell lung cancer.However,prognosis in non-small cell lung cancer can not be judged by only a single index.