非小细胞肺癌患者血清骨膜蛋白水平对化疗效果的评估价值

Serum periostin level in evaluating efficacy of chemotherapy in patient with non-small cell lung cancer

目的探讨非小细胞肺癌(NSCLC)患者血清骨膜蛋白水平对化疗效果的评估价值。方法连续性纳入110例NSCLC患者(NSCLC组)、64例肺部良性病变(良性组)和60例健康体检志愿者(对照组)。检测所有患者入院时以及NSCLC患者化疗结束后1d的血清骨膜蛋白水平,同时参考实体肿瘤反应评估标准评估化疗效果,其中完全缓解、部分缓解为有效,病情稳定、病情进展为无效。结果入院时NSCLC组血清骨膜蛋白水平分别高于良性组、对照组(均P<0.05)。化疗结束后1d,NSCLC患者血清骨膜蛋白水平明显低于入院时(P<0.05);其中有效组与无效组入院时血清骨膜蛋白水平比较,差异无统计学意义(P>0.05);化疗结束后1d两组患者均有所降低,有效组明显低于无效组(P<0.05)。入院时血清骨膜蛋白水平诊断NSCLC的截断点为535.2ng/ml,灵敏度为0.82,特异度为0.80,其AUC及95%CI为0.821(0.784~0.867);△血清骨膜蛋白水平(即入院时与化疗结束后1d差值)评估化疗有效的截断点为109.8ng/ml,灵敏度为0.85,特异度为0.81,其AUC及95%CI为0.846(0.801~0.896)。入院时血清骨膜蛋白水平与NSCLC诊断呈正相关(r=0.633,P<0.05);△血清骨膜蛋白水平与NSCLC化疗有效呈正相关(r=0.699,P<0.05)。结论NSCLC患者血清骨膜蛋白水平明显升高;而血清骨膜蛋白水平明显下降可能是NSCLC患者化疗有效的标志之一。

Objective To assess the application of serum periostin in evaluating efficacy of chemotherapy in patients with non-small cell lung cancer（NSCLC）. Methods One hundred and ten NSCLC patients（NSCLC group）, 64 patients with benign lesion（benign group） and 60 healthy subjects（control group） were enrolled in this study. Serum periostin levels were measured on admission in all subjects, and also measured after chemotherapy in NSCLC group. Chemotherapy response was assessed according to the solid tumor response assessment criteria. Complete and partial remission were classified as effective, stable condition and progression as ineffective. Results The levels of periostin in NSCLC group were higher than those in both benign group and control group on admission（P〈0.05）. The periostin levels in NSCLC group were decreased after chemotherapy（P〈0.05）. There was no significant difference in periostin levels on admission between effective and non-effective subgroups of NSCLC patients（P〈0.05）, while the periostin level in effective subgroup was lower than that in ineffective subgroup after chemotherapy（P〈0.05）. The area under ROC curve（AUC） of serum periostin level on admission for diagnosis of NSCLC was0.821（95%CI： 0.784-0.867）, with cut-off value of 535.2 ng/ml, the sensitivity and specificity were 0.82 and 0.80, respectively. The AUC of △periostin for effective chemotherapy was 0.846（95%CI：0.801-0.896）, with cut-off value of 109.8 ng/ml, the sensitivity and specificity were 0.85 and 0.81, respectively. The periostin level on admission and △periostin were both positively correlated with effective chemotherapy of NSCLC（r=0.633, 0.699, P〈0.05）. Conclusion The serum periostin level in NSCLC patients is significantly elevated and the fluctuation of serum periostin after chemotherapy may be a useful indicator for predicting curative effect of chemotherapy in NSCLC patients.