高密度脂蛋白胆固醇、铁蛋白、整合素α3与Ⅳ期非小细胞肺癌病理特征及患者生存预后的相关性

Correlation of High-density Lipoprotein Cholesterol,Ferritin and Integrin α3 with the Pathological Characteristics,Survival and Prognosis of Patients with Stage Ⅳ Non-small Cell Lung Cancer

目的 研究高密度脂蛋白胆固醇(HDL-C)、铁蛋白、整合素α3与Ⅳ期非小细胞肺癌病理特征及患者生存预后的相关性。方法 选取96例Ⅳ期非小细胞肺癌,对其进行HDL-C、铁蛋白、整合素α3水平检测,根据判断标准分为阳性与阴性,分析各指标水平阴性、阳性与Ⅳ期肺癌病理关系;随访患者生存情况,用Kaplan-Meier法及Cox比例风险回归模型分析HDL-C、铁蛋白、整合素α3水平对生存预后的影响。结果 96例患者HDL-C阴性51例、阳性45例;铁蛋白阴性42例、阳性54例;整合素α3阴性33例、阳性63例。患者性别、年龄、吸烟对HDL-C、铁蛋白、整合素α3水平表达情况无显著影响(P>0.05);鳞癌、有淋巴结转移患者HDL-C、铁蛋白、整合素α3水平阳性表达率更高(P<0.05)。经Kaplan-Meier法分析,结果显示,整体中位PFS为7.3个月,整体中位OS为22.1个月。HDL-C、铁蛋白、整合素α3阳性表达组中位PFS、OS均短于阴性表达组(P<0.05)。Cox回归模型分析显示,淋巴结转移与HDL-C、铁蛋白、整合素α3阳性表达为影响Ⅳ期非小细胞肺癌患者生存预后的独立危险因素(P<0.05)。结论 Ⅳ期非小细胞肺癌患者HDL-C、铁蛋白、整合素α3阳性表达较高,高水平表达可预示患者预后不良,可作为评估其预后有效辅助指标。

Objective To investigate the correlation of high-density lipoprotein cholesterol(HDL-C),ferritin and integrin α3 with the pathological characteristics,survival and prognosis of patients with stage Ⅳ non-small cell lung cancer.Methods 96 patients with stage Ⅳ non-small cell lung cancer were selected.HDL-C,ferritin and integrin α3 levels were tested and classified as positive or negative according to the judgment criteria,and the relationship of negative and positive status of each index with the pathology of stage Ⅳ lung cancer patients was analyzed.The survival of patients was followed up,and the effects of HDL-C,ferritin and integrin α3 levels on survival and prognosis were evaluated using Kaplan-Meier analysis and Cox proportional hazards regression model.Results In 96 patients,HDL-C was negative in 51 cases and positive in 45 cases;Ferritin was negative in 42 cases and positive in 54 cases;integrin α was negative in 33 cases and positive in 63 cases.Patients’ gender,age and smoking had no significant effect on the expression of HDL-C,ferritin and integrin α3 levels(P>0.05),while patients with squamous carcinoma and lymph node metastasis had elevated positive expression of HDL-C,ferritin and integrin α3 levels(P<0.05).Kaplan Meier analysis showed that the median progression free survival(PFS) was 7.3 months and the median overall survival(OS) was 22.1 months.Median PFS and OS were shorter in HDL-C,ferritin and integrin α3 positive expression groups than in negative expression groups(P<0.05).Cox regression model analysis showed that lymph node metastasis,positive expressions of HDL-C,ferritin and integrin α3 were independent risk factors affecting the survival and prognosis of patients with stage Ⅳ non-small cell lung cancer(P<0.05).Conclusion Patients with stage Ⅳ non-small cell lung cancer have high positive expression of HDL-C,ferritin and integrin α3,meantime,high levels of expression are predictive of poor prognosis and can be used as useful adjunctive indicators to assess their prognosis.