血清胸苷激酶1对小细胞肺癌的诊断和疗效

Diagnostic and prognostic value of serum thymidine kinase 1 in patients with small cell lung cancer

目的:探讨血清胸苷激酶1(TK1)诊断以及预测依托泊苷(VP-16)联合铂类方案(EP)治疗小细胞肺癌患者的疗效评估。方法:选取57例小细胞肺癌患者与57例肺部良性疾病对照组,应用免疫印迹-增强化学发光法检测两组s TK1的浓度,并比较治疗前及化疗4次后各临床常见肿瘤指标的水平,结合临床资料,探讨血清TK1在诊断小细胞肺癌以及疗效评价方面的意义。结果:TK1检测诊断小细胞肺癌的ROC曲线下面积为0.837,其灵敏度高于NSE;患者中TK1的表达与小细胞肺癌临床分期(P=0.019)及化疗后疗效(P=0.000)有关,与性别、年龄、是否吸烟无显著相关(P>0.05);TK1在治疗前小细胞肺癌中的水平明显高于对照组(P<0.05),在化疗2个周期、4个周期的患者中其水平逐渐降低,组间差异有统计学意义(P<0.05)。结论 :TK1可作为小细胞肺癌患者的早期诊断及化疗疗效评估指标,在判断临床病情变化及治疗上具有重要指导意义。

Objective To investigate the predictive and prognostic value of serum thymidine kinase 1 （TK1） of small cell lung cancer after etoposide （VP-16） combined platinum scheme （EP） treatment. Methods Concentration of sTK1 levels was detected in paralM in patients with SCLC （n = 57） and benign controls （n = 57） by chemoluminescent dot blot assay, the levels of tumor makers before and after four cycles first-line chemotherapy and combined with clinical data were compared to evaluate the efficacy of sTK1 in small cell lung cancer. Results The diagnosis of sTK1 in the area under the ROC curve was 0.837 and its sensitivity was higher than that of NSE. Moreover, sTK1 expression in patients with SCLC was closely related with clinical stage （P = 0.019） and effect after chemotherapy （P = 0.000）,but not with sex,age and smoking （P 〉 0.05） ; sTK1 level before the treatment was significantly higher than that in control group （P 〈 0.05） and sTK1 level of patients with 2-cycle,4-cycle chemotherapy had a descending trend between groups, which was statistically significant （P 〈 0.05）. Conclusion sTK1 can serve as a effective tumor maker of SCLC and evaluating chemotherapy curative effect and it has significant value in monitoring the progression and treatment of patients.