血清骨形态发生蛋白水平与非小细胞肺癌预后的关系

Relationship between serum bone morphogenetic protein level and prognosis of non-small cell lung cancer

目的评价血清骨形态发生蛋白-2(BMP-2)水平对非小细胞肺癌(NSCLC)患者预后的影响。方法选取2017年1月—12月河北省唐山市人民医院收治的57例NSCLC患者,采集患者临床病理特征和总生存数据,检测患者血清BMP-2的水平。分析患者血清BMP-2水平与临床病理特征的关系以及肺癌患者血清BMP-2水平与预后的关系,应用单因素和多因素生存分析探讨BMP-2水平及其他临床病理因素对于NSCLC患者的影响。结果不同病理分期、转移部位数患者血清BMP-2水平比较,差异有统计学意义(P<0.05)。不同年龄、性别、组织学类型及肿瘤细胞分化程度患者血清BMP-2水平比较,差异无统计学意义(P>0.05)。所有患者中位生存时间为9.8个月(95%CI:7.3~11.5)。高BMP-2水平NSCLC患者中位生存期为6.8个月(95%CI:4.5~9.3)短于低BMP-2水平NSCLC患者12.1个月(95%CI:9.4~14.8),差异有高度统计学意义(χ^2=9.15,P<0.001)。单因素生存分析发现病理分期为Ⅳ期(HR=1.539,95%CI:1.127~3.228,P=0.013)、转移部位数(≥3处)(HR=1.738,95%CI:1.194~4.380,P=0.001)和BMP-2水平(≥75 pg/mL)(HR=2.019,95%CI:1.233~6.229,P=0.000)是影响NSCLC患者预后的不良因素。多因素生存分析显示血清BMP-2水平(≥75 pg/mL)(HR=1.837,95%CI:1.146~3.473,P=0.007)和转移部位数(≥3处)(HR=1.199,95%CI:1.028~2.337,P=0.037)是影响NSCLC患者预后的独立不良因素。结论血清高BMP-2水平和转移部位数超过3个是NSCLC患者的独立预后不良因素,可预测NSCLC预后。

Objective To evaluate the effect of serum bone morphogenetic protein-2(BMP-2)level on the prognosis of patients with non-small cell lung cancer(NSCLC).Methods A total of 57 NSCLC patients admitted to Tangshan People’s Hospital,Hebei Province from January to December 2017 were selected.Clinicopathological features and overall survival data of the patients were collected and the serum BMP-2 level of the patients were detected.The relationship between serum BMP-2 level and clinicopathological characteristics and the relationship between serum BMP-2 level and prognosis in patients with lung cancer were analyzed,and the influence of BMP-2 level and other clinicopathological factors on patients with NSCLC was discussed by univariate and multivariate survival analysis.Results The difference of serum BMP-2 level in patients with different pathological stages and metastatic sites was statistically significant(P<0.05).There was no significant difference in serum BMP-2 level among patients with different age,sex,histological type and degree of tumor cell differentiation(P>0.05).The median survival time of all patients was 9.8 months(95%CI:7.3-11.5).The median survival time of NSCLC patients with high BMP-2 level was 6.8 months(95%CI:4.5-9.3),shorter than that of NSCLC patients with low BMP-2 level was 12.1 months(95%CI:9.4-14.8),the difference was highly statistically significant(χ^2=9.15,P<0.001).Single factor survival analysis found that the pathological stageⅣ(HR=1.539,95%CI:1.127-3.228,P=0.013),number of metastatic sites(≥three sites)(HR=1.738,95%CI:1.194-4.380,P=0.001)and BMP-2 levels(≥75 pg/mL)(HR=2.019,95%CI:1.233-6.229,P=0.000)were the adverse factors affecting the prognosis of patients with NSCLC.Multivariate survival analysis showed that serum BMP-2 level(≥75 pg/mL)(HR=1.837,95%CI:1.146-3.473,P=0.007)and number of metastatic sites(≥three sites)(HR=1.199,95%CI:1.028-2.337,P=0.037)were independent adverse factors affecting the prognosis of NSCLC patients.Conclusion High serum BMP-2 level and more than three metastatic sites are independent adverse prognostic factors for NSCLC patients,which can predict the prognosis of NSCLC.