非小细胞肺癌患者化疗疗效与可溶性细胞间黏附分子-1、P-糖蛋白、p53及CT灌注成像参数的相关性

Correlation between the chemotherapy response in patients with non-small cell lung cancer and soluble intercellular adhesion molecule-1,P-glycoprotein,p53 and CT perfusion imaging parameters

目的:探讨可溶性细胞间黏附分子-1(sICAM-1)、P-糖蛋白(P-gp)、抑癌基因p53(p53)及CT灌注成像参数与非小细胞肺癌(NSCLC)患者化疗疗效的相关性。方法:选取2020年1月至2023年1月北海市人民医院心胸血管外科治疗的晚期NSCLC患者86例,所有患者给予铂类为主的化疗方案,根据化疗效果将患者分为化疗有效组和化疗无效组,其中化疗有效患者37例,化疗无效患者49例,分析化疗有效和无效患者临床资料、sICAM-1、P-gp、p53及CT灌注成像参数差异。计量资料使用t检验、方差检验或非参数检验分析组间差异;对于计数资料采用χ^(2)检验分析组间差异。结果:TNM分期Ⅳ期的化疗无效患者为30例,高于化疗有效患者(16例)(χ^(2)=4.455,P<0.05);肿瘤低分化的化疗无效患者和化疗有效患者分别为27例和13例,化疗无效患者的肿瘤低分化例数比有效患者高(χ^(2)=4.982,P<0.05);化疗无效患者化疗前外周血sICAM-1为(910.02±98.70)ng/ml,明显高于化疗有效患者(Z=-6.654,P<0.001);化疗无效患者化疗前组织P-gp和p53阳性率分别为70.21%和55.32%,明显高于化疗有效患者(χ^(2)=5.112,P<0.05;χ^(2)=6.392,P<0.05);化疗无效患者化疗前血流量(BF)为(65.56±11.02)ml/(100 ml·min),明显低于化疗有效患者(t=9.713,P<0.01)。TNM分期Ⅳ期患者化疗前sICAM-1、P-gp、p53阳性率分别为(875.00±86.65)ng/ml、73.91%和56.52%,明显高于TNM分期ⅢB期患者(Z=-4.650,P<0.001;χ^(2)=8.748,P<0.01;χ^(2)=7.351,P<0.01);低分化患者化疗前sICAM-1、P-gp、p53阳性率分别为(872.99±88.34)ng/ml、87.50%和57.50%,明显高于中高分化患者(Z=4.243,P<0.001;χ^(2)=24.637,P<0.001;χ^(2)=6.394,P<0.05);TNM分期Ⅳ期患者化疗前BF为(70.89±9.17)ml/(100 ml·min),明显低于TNM分期ⅢB期患者(t=7.368,P<0.001)。低分化患者化疗前BF为(71.75±9.34)ml/(100 ml·min),明显低于中高分化患者(t=-6.366,P<0.001)。结论:sICAM-1、P-gp、p53及CT灌注成像参数BF与NSCLC患者化疗疗效和NSCLC患者TNM分期、分化程度有关。

Objective To investigate the correlation between soluble intercellular adhesion molecule-1(sICAM-1),P-glycoprotein(P-gp),tumor suppressor gene p53,and CT perfusion imaging parameters with the chemotherapy response in patients with non-small cell lung cancer(NSCLC).Methods A total of 86 patients with advanced NSCLC treated in the Department of Cardiothoracic and Vascular Surgery in Ninth Clinical Medical College of Guangxi Medical University from January 2020 to January 2023 were enrolled in this study.All patients received platinum-based chemotherapy.Based on the chemotherapy response,the patients were divided into two groups:effective chemotherapy group(n=37)and ineffective chemotherapy group(n=49).The differences in clinical data,sICAM-1,P-gp,p53,and CT perfusion imaging parameters were analyzed between the two groups.For continuous variables,the t-test,ANOVA,or non-parametric test was used to analyze the differences between groups.For categorical variables,the Chi-square test was used to analyze the differences between groups.Results Totally,30 patients in the ineffective chemotherapy group were at TNM stageⅣ,which was more than that in the effective chemotherapy group(n=16)(χ^(2)=4.455,P<0.05).There were 27 patients with poorly differentiated tumors in the ineffective chemotherapy group,which were more than in the effective chemotherapy group(n=13)(χ^(2)=4.982,P<0.05).The peripheral blood sICAM-1 level before chemotherapy in the ineffective chemotherapy group was significantly higher(910.02±98.70 ng/ml)than in the effective chemotherapy group(Z=-6.654,P<0.001).The positive rate of tissue P-gp and p53 before chemotherapy in the ineffective chemotherapy group were 70.21%and 55.32%,respectively,which was significantly higher than that in the effective chemotherapy group(P-gp:χ^(2)=5.112,P<0.05;p53:χ^(2)=6.392,P<0.05).The blood flow(BF)before chemotherapy in the ineffective chemotherapy group(65.56±11.02)ml/(100 ml·min)was significantly greater than in the effective chemotherapy group(t=9.713,P<0.01).For patients at TNM stageⅣ,the levels of sICAM-1,P-gp,and p53 before chemotherapy were significantly higher than those in patients at TNM stageⅢB[sICAM-1:(875.00±86.65)ng/ml,Z=-4.650,P<0.001;P-gp:73.91%,χ^(2)=8.748,P<0.01;p53:56.52%,χ^(2)=7.351,P<0.01].For patients with poorly differentiated tumors,the levels of sICAM-1,P-gp,and p53 before chemotherapy were significantly higher than those in patients with moderate-to well-differentiated tumors(sICAM-1:872.99±88.34 ng/ml,Z=4.243,P<0.001;P-gp:87.50%,χ^(2)=24.637,P<0.001;p53:57.50%,χ^(2)=6.394,P<0.05).The BF before chemotherapy in patients at TNM stageⅣ(70.89±9.17)ml/(100 ml·min)was significantly lower than that in patients at TNM stageⅢB(t=7.368,P<0.001).The BF before chemotherapy in patients with poorly differentiated tumors(71.75±9.34)ml/(100 ml·min)was significantly lower than that in patients with moderate-to well-differentiated tumors(t=-6.366,P<0.001).Conclusion The levels of sICAM-1,P-gp,p53,and the CT perfusion imaging parameter BF are associated with the chemotherapy response,TNM staging,and the degree of differentiation in patients with NSCLC.