血清乳酸脱氢酶与NSCLC患者骨转移的相关性分析

Analysison the Correlation of Serum Lactate Dehydrogenase and Bone Metastasis in NSCLC Patients

目的探究血清乳酸脱氢酶(LDH)与非小细胞肺癌(NSCLC)患者骨转移之间的关系,为骨转移的防治及深入研究提供依据。方法回顾性收集安徽理工大学附属肿瘤医院2014~2021a的符合纳排标准的NSCLC患者数据。首先,采用单因素方差检验比较未转移、骨转移、脑转移3组患者LDH水平差异。其次,采用单因素和多因素Logistic回归分析,评估LDH是否是NSCLC骨转移的独立影响因素。最后,使用Logistic回归模型和曲线拟合的方法评估LDH与NSCLC骨转移的线性关系,并按照年龄、性别、病理类型、T分期、N分期进行亚组分层。结果本研究共纳入193例NSCLC患者。单因素方差检验表明血清LDH在未转移与转移组间具有差异,单因素和多因素Logistic回归分析表明血清LDH是NSCLC患者发生骨转移的独立影响因素(P<0.01)。线性回归分析表明,在所有模型中LDH均与NSCLC骨转移呈正相关(模型1:OR=1.14,95%CI∶1.07~1.21;模型2:OR=1.14,95%CI∶1.07~1.22;模型3:OR=1.13,95%CI∶1.05~1.22)。按T、N分期分层,LDH仍与骨转移呈正相关,而按照年龄、性别和病理类型分层时,<60岁、女性和鳞癌患者没有显著相关性。结论血清LDH是NSCLC患者发生骨转移的独立影响因素,并且与骨转移的风险呈正相关,这为进一步深入研究LDH与NSCLC骨转移的潜在联系提供了一定的临床依据。

Objective To investigate the relationship between serum lactate dehydrogenase(LDH)and bone metastases in non-small cell lung cancer(NSCLC)patients,and to provide a basis for the prevention and treatment of bone metastases and in-depth research.Methods:Data of NSCLC patients who met the criteria of nadir were retrospectively collected from 2014 to 2021 from the Cancer Hospital of Anhui University of Technology.Firstly,the one-way ANOVA test was used to compare the differences in LDH levels among the three groups of patients with non-metastatic,bone metastasis and brain metastasis respectively.Secondly,one-way and multi-way logistic regression analyses were used to assess whether the independent influence of LDH was the independent factor for bone metastasis in NSCLC.Further,the linear relationship between LDH and NSCLC bone metastases was assessed by using logistic regression models and curve fitting,and subgroups were stratified according to the age,gender,pathological type,T-stage,and N-stage.Results:A total of 193 NSCLC patients were included in this study.One-way ANOVA test showed that serum LDH differed between the non-metastatic and metastatic groups,and one-way and multi-way logistic regression analysis showed that serum LDH was an independent influential factor in the development of bone metastasis in NSCLC patients(P<0.01).Linear regression analysis showed that LDH was positively associated with bone metastasis in NSCLC in all models(model 1:OR=1.14,95%CI∶1.07~1.21;model 2:OR=1.14,95%CI∶1.07~1.22;model 3:OR=1.13,95%CI∶1.05~1.22).Stratified by T and N stages,LDH remained positively associated with bone metastases,whereas when stratified by the age,sex and type of pathology,there was no significant correlation in patients<60 years,women and squamous carcinoma.Conclusion:Serum LDH is an independent influencing factor for the development of bone metastasis in NSCLC patients and positively associated with the risk of bone metastasis,which provides some clinical basis for further in-depth study of the potential association between LDH and bone metastasis in NSCLC.