硫氧还蛋白还原酶在肺癌疗效监测中的应用

Application of thioredoxin reductase in monitoring the curative effect of lung cancer

目的探讨血浆硫氧还蛋白还原酶(TR)在肺癌化疗疗效监测中的价值。方法将482例肺癌患者依据化疗疗效分为治疗未获益组(211例)和治疗获益组(271例),检测所有患者TR、癌胚抗原(CEA)、鳞状上皮细胞癌抗原(SCC-Ag)、细胞角蛋白19片段(CYFRA 21-1)、神经元特异性烯醇化酶(NSE)及胃泌素释放肽前体(ProGRP)水平。采用受试者工作特征(ROC)曲线评估各项指标单项及联合检测判断化疗疗效的价值。结果治疗未获益组TR、CEA及NSE水平均高于治疗获益组(P<0.05),2个组之间SCC-Ag、CYFRA21-1及ProGRP水平差异均无统计学意义(P>0.05)。治疗未获益组TR阳性率为56.40%,显著高于治疗获益组(13.16%)(P<0.05)。ROC曲线分析结果显示,TR、CEA、CYFRA 21-1、SCCAg、NSE及ProGRP单项检测判断肺癌化疗疗效的曲线下面积(AUC)分别为0.759、0.667、0.579、0.530、0.619、0.544。将各项指标进行组合,TR+CEA、TR+CEA+CYFRA21-1、TR+CEA+CYFRA21-1+NSE及TR+CEA+CYFRA 21-1+NSE+ProGRP联合检测判断肺癌化疗疗效的AUC分别为0.757、0.749、0.752和0.788。TR与CEA、NSE、SCC-Ag、CYFRA 21-1及ProGRP均无相关性(r值分别为0.05、0.02、-0.15、0.05、0.10,P>0.05)。结论TR或可作为更有效的肺癌疗效监测的生物标志物。

Objective To investigate the role of plasma thioredoxin reductase(TR)in monitoring the efficacy of chemotherapy in lung cancer.Methods Totally,482 lung cancer patients were classified into 2 groups according to the efficacy of chemotherapy,which were unbenefited group(211 cases)and benefited group(271 cases).TR,carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCC-Ag),cytokeratin 19 fragment(CYFRA 21-1),neuron-specific enolase(NSE)and gastrin-releasing peptide precursor(ProGRP)levels were determined.Receiver operating characteristic(ROC)curve was used to evaluate the roles of single and combined determinations of each indicator in judging the efficacy of chemotherapy.Results TR,CEA and NSE levels in unbenefited group were higher than those in benefited group(P<0.05),and there was no statistical significance in SCC-Ag,CYFRA 21-1 and ProGRP levels between the 2 groups(P>0.05).The positive rate of TR in unbenefited group was 56.40%,which was higher than that in benefited group(13.16%)(P<0.05).ROC curve analysis showed that the areas under curves(AUC)of TR,CEA,CYFRA 21-1,SCC-Ag,NSE and ProGRP single determinations to judge the efficacy of chemotherapy were 0.759,0.667,0.579,0.530,0.619 and 0.544,respectively.The AUC of combined determinations of TR+CEA,TR+CEA+CYFRA 21-1,TR+CEA+CYFRA 21-1+NSE and TR+CEA+CYFRA 21-1+NSE+ProGRP were 0.757,0.749,0.752 and 0.788,respectively.TR did not correlate with CEA,NSE,SCC-Ag,CYFRA 21-1 and ProGRP(r=0.05,0.02,-0.15,0.05 and 0.10,P>0.05).Conclusions TR may serve as a biomarker for monitoring lung cancer curative effect.