血清同型半胱氨酸和血清胱抑素C水平与化疗疗效的相关性研究

Variation in homocysteine and cystatin C levels and its correlation with chemotherapy efficacy in Patients with small cell lung cancer

目的:探讨血清同型半胱氨酸(homocysteine,Hcy)、血清胱抑素C(cysatin C,Cys-C)在小细胞肺癌(small cell lung cancer,SCLC)外周血中的水平及与化疗疗效的相关性。方法:选取2018年1月至2020年12月于陕西中医药大学附属医院治疗的无法手术的SCLC患者67例(观察组)及同期体检者60例(对照组)。观察组患者局限期26例,广泛期41例,分别于化疗前及依托泊苷联合铂类2周期化疗后,清晨空腹抽取静脉血,检测Hcy、Cys-C水平,并进行分析。结果:观察组患者外周血Hcy水平显著高于对照组(P<0.05),而观察组与对照组Cys-C差异无统计学意义(P>0.05);局限期与广泛期Hcy、Cys-c水平差异无统计学意义(P>0.05);局限期、广泛期分别与对照组相比,Hcy值均显著升高(均P<0.05),而Cys-C差异无统计学意义(P>0.05);有效组患者化疗后Hcy、Cys-C水平较化疗前均显著下降(均P<0.05),无效组患者化疗后Hcy、Cys-C水平较化疗前差异无统计学意义(均P>0.05)。结论:Hcy与SCLC的发生呈正相关,血清Hcy、Cys-C联合检测,可以评估SCLC患者化疗疗效,观察患者病情动态变化。

Objective:To explore variations in serum homocysteine(Hcy)and cystatin C(Cys-C)levels in patients with small cell lung cancer(SCLC)and determine the correlation between chemotherapy efficacy in patients with SCLC and Hcy and Cys-C levels.Methods:From January 2018 to December 2020,67 patients with SCLC(observation group)and 60 normal healthy people(control group)who provided informed consent were enrolled.Twenty-six limited-stage patients and 41 extensive-stage patients in the observation group were treated with etoposide combined with platinum.Hcy and Cys-C levels were detected in the observation group before and after two cycles chemotherapy and in the control group.Results:The level of Hcy in the observation group was significantly higher than that in the control group(P<0.05),while there was no statistically significant difference in Cys-C between the observation group and the control group(P>0.05).And there was no significant difference in Hcy and Cys-C levels between limited-stage patients and extensive-stage patients(P>0.05).Compared with control group,the Hcy levels in limited-stage patients and extensive-stage patients were significantly increased(P<0.05),while the Cys-C levels were not statistically significant(P>0.05).In the effective group,he levels of Hcy and Cys-C decreased significantly after chemotherapy compared with before chemotherapy(P<0.05).In the ineffective group,the levels of Hcy and Cys-C showed no statistically significant differences after chemotherapy compared with before chemotherapy(P>0.05).Conclusions:Hcy is positively correlated with the occurrence of SCLC.The combined detection of Hcy and Cys-C levels in the serum can help evaluate chemotherapy efficacy and observe dynamic changes in patients with SCLC.