广泛期小细胞肺癌化疗前后血清神经元特异性烯醇化酶、乳酸脱氢酶、血小板联合测定的价值
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摘要
目的:通过分析广泛期小细胞肺癌(ES-SCLC)患者化疗前后乳酸脱氢酶(LDH)、血小板(PLT)和神经元特异性烯醇化酶(NSE)与生存之间的关系,旨在探讨其在ES-SCLC患者预后方面的价值。方法:回顾性分析2011年3月至2016年5月于徐州医科大学附属医院经病理学确诊的ES-SCLC患者57例,用Kaplan-Meier方法、Log-rank单因素分析和COX比例模型分析患者化疗前后LDH、PLT和NSE与生存之间的关系,P <0. 05为差异有统计学意义。结果:初诊各实验室指标联合检测在广泛期小细胞肺癌患者总生存期方面差异有统计学意义(χ~2=14. 480,P <0. 001),而2周期化疗后各指标联合检测与患者总生存期无明显相关性(χ~2=2. 841,P=0. 092)。结论:初诊血清NSE、PLT、LDH水平的联合检测可理想评估ES-SCLC患者的预后。
Objective: To discuss whether neuron-specific enolase( NSE),lactate dehydroge-nase( LDH),platelet( PLT) affect the prognosis of extensive small cell lung cancer by analyzing the association between the above laboratory indicators before and after treatment and disease progression of patients. Methods: In this study,a retrospective analysis of 57 patients with ES-SCLC diagnosed by pathology at the Xuzhou Medical University Affiliated Hospital from March 2011 to May 2016 was conducted. We analysis the connection between them by Kaplan-Meier method,Log-rank test and COX proportional hazards models. Statistical significance was determined for a P value less than 0. 05. Results: Joint assessment of a number of laboratory indicators before treatment is statistically significant in the overall survival of extensive stage small cell lung cancer patients( χ~2= 14. 480,P < 0. 001),but joint assessment of those after treatment is not related to the overall survival( χ~2= 2. 841,P = 0. 092).Conclusion: Joint detection of neuron-specific enolase( NSE),lactate dehydroge-nase( LDH),platelet( PLT) before treatment is meaningful for the prognosis of extensive small cell lung cancer.
Objective: To discuss whether neuron-specific enolase( NSE),lactate dehydroge-nase( LDH),platelet( PLT) affect the prognosis of extensive small cell lung cancer by analyzing the association between the above laboratory indicators before and after treatment and disease progression of patients. Methods: In this study,a retrospective analysis of 57 patients with ES-SCLC diagnosed by pathology at the Xuzhou Medical University Affiliated Hospital from March 2011 to May 2016 was conducted. We analysis the connection between them by Kaplan-Meier method,Log-rank test and COX proportional hazards models. Statistical significance was determined for a P value less than 0. 05. Results: Joint assessment of a number of laboratory indicators before treatment is statistically significant in the overall survival of extensive stage small cell lung cancer patients( χ~2= 14. 480,P < 0. 001),but joint assessment of those after treatment is not related to the overall survival( χ~2= 2. 841,P = 0. 092).Conclusion: Joint detection of neuron-specific enolase( NSE),lactate dehydroge-nase( LDH),platelet( PLT) before treatment is meaningful for the prognosis of extensive small cell lung cancer.
引文
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[11]Yang H,Mi R,Wang Q,et al. Expression of neuron-specific enolase in multiple myeloma and implications for clinical diagnosis and treatment[J]. Plos One,2014,9(5):e94304.
[12]Dennison JB,Molina JR,Mitra S,et al. Lactate dehydrogenase B:A metabolic marker of response to neoadjuvant chemotherapy in breast cancer[J]. Clin Cancer Res,2013,19(13):3703-3713.
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[14]Jurisic V,Radenkovic S,Konjevic G. The nctual role of LDH as tumor marker,biochemical and clinical aspects[J]. Advances in Cancer Biomarkers,2015,867:115-124.
[15]Zhang X,Guo M,Fan J,et al. Prognostic significance of serum LDH in small cell lung cancer:A systematic review with meta-analysis[J]. Cancer Biomarkers,2016,16(3):415-423.
[16]Liu S,Zhang GL,Li CH,et al. Prognostic factors and survival of patients with small cell lung cancer in a northeastern Chinese population[J]. Thoracic Cancer,2013,4(2):143-152.
[17]Builbruna N,Morenojiménez M,Martínalgarra S,et al. A population pharmacodynamic model for lactate dehydrogenase and neuron specific enolase to predict tumor progression in small cell lung cancer patients[J]. Aaps Journal,2014,16(3):609-619.
[18]Hermes A,Gatzemeier U,Waschki B,et al. Lactate dehydrogenase as prognostic factor in limited and extensive disease stage small cell lung cancer-a retrospective single institution analysis[J].Respir Med,2010,104(12):1937-1942.
[19]Inomata M,Hayashi R,Tokui K,et al. Lactate dehydrogenase and body mass index are prognostic factors in patients with recurrent small cell lung cancer receiving amrubicin[J]. Tumori,2015,102(6):606-609.
[20]Gay LJ,Felding-Habermann B. Contribution of platelets to tumour metastasis[J]. Nat Rev Cancer,2011,11(2):123-134.
[21]Ozaksit G,Tokmak A,Kalkan H,et al. Value of the platelet to lymphocyte ratio in the diagnosis of ovarian neoplasms in adolescents[J]. Asian Pac J Cancer Prev,2015,16(5):2037-2041.
[22]Ji Y,Sheng L,Du X,et al. Elevated platelet count is a strong predictor of poor prognosis in stage I non-small cell lung cancer patients[J]. Platelets,2015,26(2):138-142.
[23]Kumagai S,Tokuno J,Ueda Y,et al. Prognostic significance of preoperative mean platelet volume in resected non-small-cell lung cancer[J]. Mol Clin Oncol,2015,3(1):197-201.
[2]Chen X,Fang J,Nie J,et al. Multivariate analysis of prognostic factors in the eldly patients with small cell lung cancer:A study of 160patients[J]. Chinese Journal of Lung Cancer,2014,17(1):15-23.
[3]IsgròMA,Bottoni P,Scatena R. Neuron-specific enolase as a biomarker:Biochemical and clinical aspects[J]. Adv Exp Med Biol,2015,867(2):125-143.
[4]Wójcik E,Kulpa JK,Sas-Korczyńska B,et al. Pro GRP and NSE in therapy monitoring in patients with small cell lung cancer[J].Anticancer Res,2008,28(5):302-303.
[5]Liu X,Zhang W,Yin W,et al. The prognostic value of the serum neuron specific enolase and lactate dehydrogenase in small cell lung cancer patients receiving first-line platinum-based chemotherapy[J]. Medicine,2017,96(46):8258.
[6]Emin Erbaycu A,Gunduz A,Batum O,et al. Pre-treatment and treatment induced neuron specific enolase in patients with smallcell lung cancer:An open prospective study[J]. Arch Bronconeumol,2010,46(7):364-369.
[7]Yu Xi,Zhang Binbin,Yang Bijie,et al. Correlation of lactate dehydrogenase and neuron-specific enolase with prognosis of extensive small cell lung cancer[J]. J Chin Med Univ,2017,46(5):425-428.[于溪,张彬彬,杨碧洁,等.乳酸脱氢酶和神经元特异性烯醇化酶水平与广泛期小细胞肺癌预后的关系[J].中国医科大学学报,2017,46(5):425-428.]
[8]Zhao WX,Luo JF. Serum neuron-specific enolase levels were associated with the prognosis of small cell lung cancer:A meta-analysis[J]. Tumour Biology,2013,34(5):3245-3248.
[9]Huang L,Zhou JG,Yao WX,et al. Systematic review and meta-analysis of the efficacy of serum neuron-specific enolase for early small cell lung cancer screening[J]. Oncotarget,2017,8(38):64358-64372.
[10]Li JT,Song SH,Wang T,et al. Effect of the changes of CEA,NSE and CYFRA21-1 before and after chemotherapy on the evaluation of prognosis in patients with small cell lung cancer[J]. Journal of Tianjin Medical University,2014,20(6):448-452.[李家腾,宋世辉,王田,等.小细胞肺癌患者化疗前后CEA、NSE和CYFRA21-1变化对评估预后的作用[J].天津医科大学学报,2014,20(6):448-452.]
[11]Yang H,Mi R,Wang Q,et al. Expression of neuron-specific enolase in multiple myeloma and implications for clinical diagnosis and treatment[J]. Plos One,2014,9(5):e94304.
[12]Dennison JB,Molina JR,Mitra S,et al. Lactate dehydrogenase B:A metabolic marker of response to neoadjuvant chemotherapy in breast cancer[J]. Clin Cancer Res,2013,19(13):3703-3713.
[13]Zhu Ming,Xu Yinya. Vascular endothelial growth factor and alpha hydroxybutyric acid dehydrogenase,beta 2-microglobulin and lactate dehydrogenase in the diagnosis and prognosis of nonHodgkin's lymphoma[J]. Modern Oncology,2017,25(10):1639-1642.[朱明,徐吟亚.血管内皮生长因子、α-羟丁酸脱氢酶、β2-微球蛋白和乳酸脱氢酶在非霍奇金淋巴瘤诊断及预后中的价值[J].现代肿瘤医学,2017,25(10):1639-1642.]
[14]Jurisic V,Radenkovic S,Konjevic G. The nctual role of LDH as tumor marker,biochemical and clinical aspects[J]. Advances in Cancer Biomarkers,2015,867:115-124.
[15]Zhang X,Guo M,Fan J,et al. Prognostic significance of serum LDH in small cell lung cancer:A systematic review with meta-analysis[J]. Cancer Biomarkers,2016,16(3):415-423.
[16]Liu S,Zhang GL,Li CH,et al. Prognostic factors and survival of patients with small cell lung cancer in a northeastern Chinese population[J]. Thoracic Cancer,2013,4(2):143-152.
[17]Builbruna N,Morenojiménez M,Martínalgarra S,et al. A population pharmacodynamic model for lactate dehydrogenase and neuron specific enolase to predict tumor progression in small cell lung cancer patients[J]. Aaps Journal,2014,16(3):609-619.
[18]Hermes A,Gatzemeier U,Waschki B,et al. Lactate dehydrogenase as prognostic factor in limited and extensive disease stage small cell lung cancer-a retrospective single institution analysis[J].Respir Med,2010,104(12):1937-1942.
[19]Inomata M,Hayashi R,Tokui K,et al. Lactate dehydrogenase and body mass index are prognostic factors in patients with recurrent small cell lung cancer receiving amrubicin[J]. Tumori,2015,102(6):606-609.
[20]Gay LJ,Felding-Habermann B. Contribution of platelets to tumour metastasis[J]. Nat Rev Cancer,2011,11(2):123-134.
[21]Ozaksit G,Tokmak A,Kalkan H,et al. Value of the platelet to lymphocyte ratio in the diagnosis of ovarian neoplasms in adolescents[J]. Asian Pac J Cancer Prev,2015,16(5):2037-2041.
[22]Ji Y,Sheng L,Du X,et al. Elevated platelet count is a strong predictor of poor prognosis in stage I non-small cell lung cancer patients[J]. Platelets,2015,26(2):138-142.
[23]Kumagai S,Tokuno J,Ueda Y,et al. Prognostic significance of preoperative mean platelet volume in resected non-small-cell lung cancer[J]. Mol Clin Oncol,2015,3(1):197-201.
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