甲状腺转录因子-1对不同化疗方案治疗晚期肺腺癌患者的预后价值研究

Predictive value of thyroid transcription factor 1 in the treatment of advanced lung adenocarcinoma with different chemotherapy regimens

目的探讨甲状腺转录因子-1(TTF-1)对不同化疗方案治疗晚期肺腺癌患者的预后价值。方法将2013年12月至2015年12月收治的126例晚期肺癌患者按照化疗方案的不同分为三组:培美曲塞+奈达铂组(PEM+NDP组)、培美曲塞+顺铂/卡铂组(PEM+DDP/CBP组)以及三代化疗药+顺铂/卡铂组(3G agent+DDP/CBP组)。采用电话、门诊等方式进行随访,随访截止时间为2017年4月。分析TTF-1对上述三种治疗方案疗效的预测价值。结果三种不同化疗方案在疾病控制率、客观缓解率方面差异无统计学意义(均P>0.05)。培美曲塞+奈达铂组3年生存率显著高于培美曲塞+顺铂/卡铂组以及三代化疗药+顺铂/卡铂组(9.68%比5.56%、6.80%,均P<0.05)。体力状况ECOG评分、脑转移是各化疗方案治疗预后的独立危险因素,TTF-1是培美曲塞+奈达铂治疗疗效的独立危险因素。结论 TTF-1是培美曲塞+奈达铂化疗后预后的独立危险因素,而对三代化疗药+顺铂/卡铂以及培美曲塞+顺铂/卡铂治疗预测作用不明显。

ObjectiveTo investigate the predictive value of thyroid transcription factor-1 （TTF-1） in the treatment of advanced lung adenocarcinoma with different chemotherapy regimens.MethodsA total of 126 patients with advanced lung cancer were divided into three groups according to the chemotherapy regimen, namely a pemetrexed＋nedaplatin group （PEM＋NDP group）, a pemetrexed＋cisplatin/carboplatin group （PEM＋DDP/CBP group） and a third-generation （3G） chemotherapy＋cisplatin/carboplatin group （3G agent＋DDP/CBP group）. The predictive value of TTF-1 in the above three treatment regimens was analyzed. The patients were followed up by telephone or outpatient visit until April 2017.ResultsThere were no significant differences in disease control rate or objective response rate between the three different chemotherapy regimens （all P〉0.05）. The survival rate of PEM＋NDP group was significantly higher than that of PEM＋DDP/CBP group and 3G agent＋DDP/CBP group （9.68%vs. 5.56% and 6.80%, both P〈0.05）. ECOG score and brain metastasis were independent risk factors for the prognosis of chemotherapy regimens. TTF-1 was an independent risk factor for PEM＋NDP therapy.ConclusionTTF-1 is an independent risk factor for PEM＋NDP chemotherapy, but not for 3G agent ＋ DDP/CBP or PEM＋DDP/CBP regimens.