非小细胞肺癌中表面活性蛋白A表达对以铂类为基础的化疗效果的预测价值

Prognostic value of surfactant protein A in non-small-cell lung carcinoma with platinum-based chemotherapy

目的 探讨表面活性蛋白A（SP-A）对非小细胞肺癌（NSCLC）患者预后的影响及对化疗疗效的预测价值.方法 130例接受手术治疗的NSCLC患者,腺癌98例,鳞癌26例,腺鳞癌4例,大细胞癌1例,未分化癌1例.分析其临床病理资料及SP-A表达,依据患者术后化疗与否将样本分组,分析SP-A与临床病理特征间的关系;结合术后随访的生存数据,采用Cox多元回归及Kaplan-Meier法对资料进行统计学分析.结果 SP-A阳性率为67.7％ （88/130）,其中腺癌阳性率为83.0％,鳞癌阳性率12.5％,SP-A的表达水平与患者的吸烟状态密切相关;SP-A对NSCLC患者预后没有明显影响;在接受以铂类为基础的化疗患者中,SP-A阳性组的生存期明显长于SP-A阴性组.结论 检测肺癌SP-A表达有助于预测以铂类为基础的化疗效果.

Objective To evaluate the prognostic value of surfactant protein A （SP-A） in nonsmall-cell lung carcinoma （NSCLC）.Methods We retrospectively reviewed the pathological results of 130 surgically resected NSCLC patients,who were followed up.The samples were divided into groups according to chemotherapy status.SP-A expression level was correlated with clinicopathological characteristics.Overall survival was estimated using Kaplan-Meier method.Results SP-A positive rate was 67.7% （88/130）.Multivariate logistic regression analysis revealed that SP-A expression was significantly reduced in heavy smokers.Univariate and multivariable Cox regression analysis demonstrated that only SP-A was the independent variable affecting survival in chemotherapy group.Positive SP-A predicted longer survival （Logrank test,P 〈 0.01）.Conclusion SP-A is a potential biomarker for predicting the effectiveness of platinum-based chemotherapy in NSCLC.