晚期非小细胞肺癌患者血浆D-二聚体及KI-67与临床疗效及无进展生存期的相关性分析

Correlation among plasma D-dimer,KI-67,clinical efficacy and progression-free survival in patients with advanced non-small cell lung cancer

目的探讨晚期非小细胞肿瘤(NSCLC)患者血浆D-二聚体及KI-67与临床疗效及无进展生存期的相关性。方法选取晚期NSCLC患者98例,依据KI-67表达情况分为高表达组与低表达组,选取70例肺部良性疾病患者为对照组,收集患者血浆D-二聚体的值,依据化疗结果分析统计D-二聚体及KI-67与化疗效果的关系以及不同组别患者第1、2、3次化疗前血浆D-二聚体变化情况。结果①血浆D-二聚体及KI-67的表达水平与肺癌患者的年龄、性别、吸烟史、转移情况、肿瘤病理类型以及肿瘤分期均无相关性;②化疗2个周期之后,有效的晚期NSCLC患者D-二聚体为(1.10±1.19)mg/L,无效患者为(1.72±1.32)mg/L,差异有统计学意义(P<0.05),化疗2个周期之后,KI-67低表达患者与高表达患者中有效的患者分别为26例与29例,差异具有统计学意义(P<0.05);③3次化疗后KI-67高表达患者血浆D-二聚体值升高,差异有统计学意义(P<0.05);④晚期NSCLC患者的PFS中位数为8.4个月,化疗前D-二聚体KI-67与无进展生存时间均呈负相关(r=-0.371,P=0.001;r=-0.612,P=0.002)。结论晚期NSCLC患者化疗前D-二聚体和KI-67表达水平升高,提示肺癌的诊断。监测D-二聚体,可提示肿瘤进展情况,及时调整治疗方案,改善患者PFS。

Objective To investigate the correlation among plasma D-dimer,KI-67,clinical efficacy and progression-free survival(PFS)in patients with advanced non-small cell lung cancer(NSCLC).Methods Ninety-eight patients with advanced NSCLC were recruited and divided into the high expression group and low expression group based on the expression of KI-67.Seventy patients with benign lung diseases were recruited as the control group.Plasma D-dimer was measured for the patients.The relationship among D-dimer,KI-67 and efficacy of chemotherapy was statistically analyzed.The changes in plasma D-dimer before start of the first,second,and third-cycle chemotherapy were recorded for the both groups of patients.Results①The expression of plasma D-dimer and KI-67 was not correlated with patient age,gender,smoking history,metastasis,pathological type and tumor staging of lung cancer.②After two cycles of chemotherapy,the level of plasma D-dimer was(1.10±1.19)mg/L in patients with advanced NSCLC who responded to the treatment(PR+SD),and was(1.72±1.32)mg/L in those who did not,with statistical difference(P<0.05).After two cycles of chemotherapy,26 patients in the KI-67 low expression group vs 29 in the KI-67 high expression responded to the treatment(PR+SD),with statistical difference(P<0.05).③After three cycles of chemotherapy,there was an increase in plasma D-dimer in patients of the KI-67 high expression group,with statistical difference(P<0.05).④The median PFS of patients with advanced NSCLC was 8.4 months.The plasma D-dimer and KI-67 levels before chemotherapy were negatively correlated with PFS(r=-0.371,P=0.001;r=-0.6118,P=0.002).Conclusion The expression of D-dimer and KI-67 is up-regulated in patients with advanced NSCLC,which can be diagnostic of lung cancer.Monitoring D-dimer may allow for tracking of tumor progression,timely adjustment of treatment protocol,and improvement of patient PFS.