血浆心脏型脂肪酸结合蛋白对非小细胞肺癌诊断和预后的价值研究

Study on the value of plasma heart fatty acid⁃binding protein in diagnosis and prognosis evaluation of non⁃small cell lung cancer

目的研究血浆心脏型脂肪酸结合蛋白(heart⁃type fatty acid⁃binding protein,H⁃FABP)对非小细胞肺癌(non⁃small cell lung cancer,NSCLC)诊断及患者预后的价值。方法回顾性分析2020年6月至2021年11月4海军军医大学第一附属医院收治的252例NSCLC患者(研究组)和270例非肺癌患者(对照组)的临床资料,采用受试者操作特征(receiver oper⁃ating characteristic,ROC)曲线和Logistic回归分析分析血浆H⁃FABP水平在NSCLC诊断和预后评估中的价值。结果血浆H⁃FABP水平诊断肺癌的曲线下面积(area under the curve,AUC)为0.74(95%CI:0.70~0.78,P<0.01)。有吸烟史、饮酒史、淋巴结转移以及TNM[T(肿瘤原发灶的情况,tumor),N(区域淋巴结受累情况,node),M(远处转移,metastasis)]分期较高的肺癌患者中血浆H⁃FABP水平较高(P>0.05)。单因素Logistic回归分析结果显示,年龄≥60岁、有吸烟史、有饮酒史、有淋巴结转移以及TNM分期Ⅲ/Ⅳ期、血浆H⁃FABP高水平与NSCLC患者预后不良有关(P<0.05)。多因素Logistic回归分析结果显示,年龄≥60岁、有吸烟史、有饮酒史、有淋巴结转移、TNM分期为Ⅲ/Ⅳ期、血浆H⁃FABP高表达均是NSCLC患者预后不良的独立危险因素(P<0.05)。结论血浆H⁃FABP是NSCLC的诊断标志物,高水平的血浆H⁃FABP与NSCLC患者不良预后相关。

Objective To study the value of plasma heart fatty acid⁃binding protein(H⁃FABP)in the diagnosis and prognosis evaluation of non⁃small cell lung cancer(NSCLC).Methods An analysis of the clinical data of 252 NSCLC patients(the study group)and 270 non⁃NSCLC patients(the control group)admitted to the First Affiliated Hospital of Naval Mmedical University from June 2020 to November 2021 was made retrospectively.The receiver operating curve(ROC)and Logistic regression were used to analyze the value of plasma H⁃FABP levels in the diagnosis and prognosis evaluation of NSCLC.Results The area under the curve(AUC)of plasma H⁃FABP level in the diagnosis of NSCLC was 0.74(95%CI:0.70⁃0.78)(P<0.01).The H⁃FABP expression levels in lung cancer patients with smoking/drinking history,lymph node metastasis,and higher tumor node metastasis(TNM)stages(stage III and IV)were obviously higher(P>0.05).The results of univariate Logistic regression analyses showed that age≥60 years old,smoking/drinking,lymph node metastasis,TNM stage III/IV and high expression of H⁃FABP were related with poor prognosis of NSCLC patients(P<0.05).The results of multivariate Logistic regression analysis also revealed that age(≥60 years),smoking/drinking history,lymph node metastasis,TNM stage III/IV and high expression of H⁃FABP were all independent risk factors for poor prognosis of NSCLC patients(P<0.05).Conclusion Plasma H⁃FABP is an early diagnostic marker of NSCLC and high level of H⁃FABP is related with poor prognosis of NSCLC patients.