肺腺癌患者血清TFF3的表达水平及其预后意义

Expression of serum TFF3 in patients with lung adenocarcinoma and its prognostic significance

目的分析肺腺癌患者血清三叶因子3(TFF3)的表达水平,探讨其对肺腺癌预后评估的意义。方法选取2015年1月至2018年12月于海安市中医院肿瘤科和呼吸科接受治疗的肺腺癌患者89例作为肺癌组,另选取同期体检合格者30例作为对照组。采用酶联免疫吸附(ELISA)法检测两组研究对象血清TFF3水平;绘制受试者工作特征(ROC)曲线评估TFF3对肺腺癌预后预测的价值;根据TFF3预测肺腺癌预后的截断值将患者分为TFF3高水平组48例(TFF3≥12.73 ng/mL)和TFF3低水平组41例(TFF3<12.73 ng/mL)。对肺腺癌组患者随访5~36个月采用Kaplan-Meier法进行生存分析,通过Log-rank法比较两组生存情况的差异。采用Cox多因素回归分析影响肺腺癌预后的危险因素。结果肺癌组血清TFF3水平高于对照组,差异有统计学意义(P<0.05);TFF3预测术后肺腺癌患者死亡的最佳临界点为12.73 ng/mL,灵敏度81.2%,特异度64.3%,ROC曲线下面积(AUC)为0.794;Spearman相关分析显示,血清TFF3水平与肿瘤体积、淋巴结转移情况及临床分期呈正相关(r=0.464、0.324、0.436,P均<0.05);生存分析结果显示,TFF3低水平组肺腺癌患者3年生存率高于TFF3高水平组(75.60%比42.75%,Log-rankχ^(2)=18.371,P<0.001)。Cox单因素分析,结果显示肿瘤大小、临床分期、淋巴结转移以及TFF3水平与患者术后总生存期有关(P<0.05);Cox多因素分析表明,较大的肿瘤体积、较高的临床分期以及TFF3的高表达是影响患者术后总生存期的危险因素(HR=3.232、3.721、4.643,P均<0.05)。结论肺腺癌患者血清TFF3的表达水平明显高于正常健康人群;肺腺癌患者TFF3的高表达与患者不良预后相关。

Objective To investigate the expression level of serum TFF3 in patients with lung adenocarcinoma and its prognostic sig-nificance.Methods A total of 89 patients with lung adenocarcinoma and 30 healthy persons who were treated in Hai'an People's Hospital from January 2015 to December 2018 were selected as lung cancer group and control group respectively.The levels of serum TFF3 in the two groups was detected by ELISA;Receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of TFF3 in the diagno-sis and prognosis of lung adenocarcinoma.;According to the cutoff value of TFF3 in predicting the prognosis of lung adenocarcinoma,the pa-tients were divided into 48 cases in the high level group of TFF3(TFF3≥12.73 ng/mL)and 41 cases in the low level group of TFF3(TFF3<12.73 ng/mL).Patients with lung adenocarcinoma were followed up for 5~36 months.Kaplan Meier survival curve and log rank analysis were used to evaluate the prognostic value of TFF3 level.Cox regression was used to analyze whether TFF3 was an independent factor affecting the prognosis of lung adenocarcinoma.Results The level of serum TFF3 in the lung cancer group was significantly higher than that in healthy control group(P<0.05);The best critical point of TFF3 for predicting the death of postoperative lung adenocarcinoma patients was 12.73 ng/mL.When TFF3 was 12.73 ng/mL,the sensitivity and specificity of TFF3 for predicting the death of postoperative lung adenocarcinoma pa-tients was 81.2%and 64.3%respectively.The area under ROC curve(AUC)was 0.794,Spearman correlation analysis showed that serum TFF3 level was positively correlated with tumor volume,lymph node metastasis and clinical stage,and the correlation coefficient r was 0.464,0.324 and 0.436,respectively(P<0.05);Kaplan Meier survival analysis and log rank test showed that the 3-year survival rate of lung adenocarcinoma patients in the low level group of TFF3 was significantly higher than that in the high level group of TFF3(75.60%vs 42.75%,Log-rankχ^(2)=18.371,P<0.001);Cox univariate analysis showed that tumor volume,clinical stage,lymph node metastasis and TFF3 were related to the over-all survival(P<0.05);Multivariate Cox analysis showed that larger tumor volume,higher clinical stage and high expression of TFF3 were inde-pendent factors affecting the overall survival of patients(HR=3.232,3.721,4.643,P<0.05).Conclusion The expression level of serum TFF3 in patients with lung adenocarcinoma is significantly higher than that in normal healthy people;The high expression of TFF3 in patients with lung adenocarcinoma is associated with poor prognosis.