非小细胞肺癌化疗期间检测血清Tim-4的临床意义

The clinical significance of detecting serum Tim-4 during chemotherapy in patients with NSCLC

目的:探讨非小细胞肺癌(NSCLC)患者化疗期间检测血清T 细胞免疫球蛋白和黏蛋白域分子4 (T cellimmunoglobulin and mucin-domain-containing molecules 4, Tim-4)水平对疾病进展评估的临床价值。方法:回顾性分析我院收治的49例NSCLC患者的资料,检测其首次、第3次、第5次化疗前血清Tim-4水平,对其作相关分析。结果:(1)第3次、第5次化疗前,缓解期、稳定期、进展期血清Tim-4水平比较差异均有统计学意义(P <0.05);(2)第3次、第5次化疗前,进展期患者血清Tim-4 水平均明显高于稳定期+缓解期患者(P<0.05);血清Tim-4 水平预测疾病进展的ROC 曲线下面积(AUC)分别为0.855 (95%CI:0.746~0.963)和0.856 (95%CI:0.728~0.983)(P<0.01);(3)对于治疗反应方面,第3次、第5 次化疗前血清Tim-4 水平预测治疗反应欠佳者的AUC分别为0.813 (95%CI:0.666~0.959)和0.854 (95%CI:0.730~0.978)(P<0.05);此外,缓解期血清Tim-4 水平均低于稳定期+进展期(P <0.05)。结论:随访NSCLC患者化疗期间血清Tim-4 水平的变化,对预测疾病进展、识别化疗反应欠佳的患者提供了有意义的评估信息,以利于治疗方案的及时调整。

Objective: To investigate the clinical value of assessment of disease progression for detection of the serum T cell immunoglobulin and mucin-domain-containing molecules 4 (Tim-4) levels in patients with non-small cell lung cancer (NSCLC) during chemotherapy. Methods: A total of 49 NSCLC patients were analyzed retrospectively, serum Tim-4 levels were measured before the 1st, the 3rd and 5th chemotherapy. And the correlation analysis were made. Results:(1)Before the 3rd and 5th chemotherapy, there were differences in serum Tim-4 levels during partial remission, stable, and advanced stages(P < 0.05).(2) Before the third and fifth chemotherapy, the serum Tim-4 level in the advanced stage were significantly higher than that in the stable and remission stage (P<0.05). And the area under the ROC curve (AUC) for predicting disease progression by serum Tim-4 levels were 0.855 (95%CI: 0.746-0.963) and 0.856 (95%CI: 0.728-0.983) respectively (P <0.01).(3) For the treatment response, before the 3rd and 5th chemotherapy, the AUC of serum Tim-4 level predicting the patients with poor response were 0.813 (95%CI: 0.666-0.959) and 0.854 (95%CI:0.730-0.978) respectively (P <0.05). In addition, serum Tim-4 in remission stage were lower than stable plus advanced stage patients (P <0.05). Conclusion: The follow-up of serum Tim-4 levels during chemotherapy in patients with NSCLC provides meaningful assessment information for patients with predicting disease progression and identifying poor response to chemotherapy, in order to facilitate the timely adjustment of the treatment plan.