血清PCNA、MIC-1及Hcy水平与非小细胞肺癌患者预后的相关性分析

Correlation analysis of serum PCNA,MIC-1,and Hcy levels and prognosis in patients with non-small cell lung cancer

目的探讨血清增殖细胞核抗原(Proliferating cell nuclear antigen,PCNA)、巨噬细胞抑制因子-1(Macrophage inhibitory cytokine-1,MIC-1)及同型半胱氨酸(Homocysteine,Hcy)水平与非小细胞肺癌(Non-small cell lung cancer,NSCLC)患者预后(总生存期)的相关性。方法回顾性分析2016年2月~2018年1月本院收治的123例NSCLC患者的临床资料,病理类型:腺癌71例、鳞癌52例。检测所有患者入院24 h内血清PCNA、MIC-1及Hcy水平[其中血清PCNA、MIC-1水平采用酶联免疫吸附法(ELISA)测定、血清Hcy水平采用循环酶法测定],并采用单因素与多因素COX回归分析以及绘制受试者工作特征曲线(ROC曲线)探讨血清PCNA、MIC-1及Hcy水平与NSCLC患者临床病理指标、预后之间的相关性。结果不同性别、年龄以及病理类型的NSCLC患者血清PCNA、MIC-1及Hcy水平比较均无明显差异(均P>0.05);而不同TNM分期、分化程度NSCLC患者血清PCNA、MIC-1及Hcy水平比较均差异明显(均P<0.05)。以NSCLC患者预后为因变量,对单因素分析中NSCLC患者预后的可能影响因素进行多因素COX回归分析,结果显示TNM分期、分化程度、PCNA、MIC-1、Hcy均为NSCLC患者预后的独立危险因素(均P<0.05)。血清PCNA≤452 pg/mL患者总生存期(16.85±2.36)个月明显大于血清PCNA>452 pg/mL患者(9.53±1.48)个月(t=20.029,P<0.001);血清MIC-1≤1000 pg/mL患者总生存期(18.29±2.92)个月,明显大于血清MIC-1>1000 pg/mL患者(9.47±1.26)个月(t=23.289,P<0.001);血清Hcy≤22μmol/L患者总生存期(13.76±2.04)个月,明显大于血清Hcy>22μmol/L患者(11.61±1.68)个月(t=6.405,P<0.001)。结论TNM分期、肿瘤分化程度较低、PCNA、MIC-1以及Hcy均为NSCLC患者预后的独立危险因素,且血清PCNA、MIC-1及Hcy呈低表达水平的NSCLC患者总生存期较长。

Objective To discuss the correlation between serum proliferating cell nuclear antigen(PCNA),macrophage inhibitory cytokine-1(MIC-1),and Homocysteine(Hcy)levels with prognosis(overall survival)in patients with non-small cell lung cancer(NSCLC).Methods The clinical data of 123 NSCLC patients treated in our hospital from Feb 2019 to Jan 2018 were retrospectively analyzed,including 71 adenocarcinoma cases and 52 squamous cell carcinoma cases.The serum PCNA,MIC-1,and Hcy levels of all patients were detected within 24 hours after admission(the serum levels of PCNA and MIC-1 were determined by ELISA,and the serum levels of Hcy were determined by the circulating enzyme method).The univariate and multivariate Cox regression analysis and receiver operating characteristic curve(ROC curve)were used to explore the correlation between the serum PCNA,MIC-1,Hcy levels with the clinicopathological indexes and prognosis of NSCLC patients.Results There were no significant differences in serum PCNA,MIC-1,and Hcy levels in NSCLC patients of different genders,ages,and pathological types(all P>0.05),while there were significant differences in serum PCNA,MIC-1,and Hcy levels in NSCLC patients with different TNM stages and degrees of differentiation(all P<0.05).Taking the prognosis of patients with NSCLC as the dependent variable,multivariate Cox regression analysis was used to analyze the possible influence factors for the prognosis of NSCLC patients in univariate analysis,the results showed that TNM stage,degree of differentiation,PCNA,MIC-1,and Hcy were independent risk factors for the prognosis of NSCLC patients(all P<0.05).The overall survival time of patients with serum PCNA≤452 pg/mL(16.85±2.36)months was significantly longer than patients with serum PCNA>452 pg/mL(9.53±1.48)months(t=20.029,P<0.001);The overall survival time of patients with serum MIC-1≤1000 pg/mL(18.29±2.92)months was significantly longer than patients with serum MIC-1>1000 pg/mL(9.47±1.26)months(t=23.289,P<0.001).The overall survival time of patients with serum Hcy≤22μmol/L(13.76±2.04)months was significantly longer than patients with serum Hcy>22μmol/L(11.61±1.68)months(t=6.405,P<0.001).Conclusion The TNM stage,low degree of tumor differentiation,PCNA,MIC-1,and Hcy were independent risk factors for the prognosis of NSCLC patients,and the patients with low expression of serum PCNA,MIC-1,and Hcy had longer overall survival.