非小细胞肺癌患者血清DJ-1、sMICA水平与临床病理特征及预后的关系研究

Analysis of relationship of serum levels of DJ-1 and sMICA with clinicopathological features and prognosis in patients with non-small cell lung cancer

摘要:

目的 探讨非小细胞肺癌（NSCLC）患者血清DJ-1蛋白（DJ-1）、可溶性MHC-I类链相关蛋白A（sMICA）水平与临床病理特征及预后的关系。方法 选取2015年1月—2017年1月沧州市中心医院收治的77例NSCLC患者为NSCLC组，同期选取该院50例体检健康者为对照组。采用酶链免疫吸附试验检测血清DJ-1、sMICA水平，分析血清DJ-1、sMICA水平与NSCLC患者临床病理特征的关系。绘制Kaplan-Meier生存曲线分析血清DJ-1、sMICA水平与NSCLC患者生存预后的关系，以随访期间肿瘤复发、转移、死亡为预后不良，分析NSCLC患者预后不良的影响因素。结果 NSCLC组患者血清DJ-1、sMICA水平高于对照组（P <0.05）。低中度分化、淋巴转移、远处转移患者血清DJ-1水平高于高度分化、无淋巴转移、无远处转移患者（P <0.05）。TNM分期Ⅲ和Ⅳ期、低中度分化、淋巴转移患者血清sMICA水平高于TNM分期Ⅰ和Ⅱ期、高度分化、无淋巴转移患者（P <0.05）。高DJ-1水平或高sMICA水平的NSCLC患者无疾病进展生存率和整体生存率低于低DJ-1水平或低sMICA水平的NSCLC患者（P <0.05）。多因素Cox回归分析结果显示：淋巴结转移［R^R=1.697（95% CI：1.421，1.953）］、分化程度［R^R=1.344（95% CI：1.194，1.648）］、DJ-1水平［R^R=1.831（95% CI：1.652，2.354）］及sMICA水平［R^R=2.164（95% CI：2.012，3.956）］是NSCLC患者预后不良的影响因素（P <0.05）。结论 NSCLC患者血清DJ-1、sMICA水平均升高，高水平DJ-1、sMICA与NSCLC患者侵袭、转移及不良预后有关。DJ-1、sMICA可以作为辅助评估NSCLC患者预后的血清生物学指标。

Abstract:

Objective To investigate the relationship between serum levels of DJ-1 protein (DJ-1) and soluble MHC-I chain associated protein A (sMICA) with clinicopathological features and prognosis in patients with non-small cell lung cancer (NSCLC).Methods From January 2015 to January 2017, 77 patients with NSCLC (NSCLC group) and 50 patients with normal physical examination (control group) were selected from the oncology department of our hospital. Serum levels of DJ-1 and sMICA were detected by enzymatic chain immunosorbent assay, and the relationship of serum levels of DJ-1 and sMICA with clinicopathological parameters of patients with NSCLC were analyzed. Kaplan Meier survival curve analysis of the relationship between the serum levels of DJ-1, SMICA, and the prognosis of patients with NSCLC. Tumor recurrence, metastasis and death were regarded as poor prognosis during follow-up. The influencing factors of the poor prognosis were analyzed.Results The serum levels of DJ-1 and sMICA in NSCLC patients were higher than those in control group (P < 0.05). Serum DJ-1 levels in patients with low and moderate differentiation, lymphatic metastasis and distant metastasis were higher than those in patients with high differentiation, no lymphatic metastasis and distant metastasis (P < 0.05). The levels of serum sMICA in patients with TNM stage Ⅲ and Ⅳ, low moderate differentiation and lymphatic metastasis were higher than those in patients with TNM stage ⅠandⅡ, high differentiation and no lymphatic metastasis (P < 0.05). The progression-free survival (PFS) rate and overall survival (OS) rate in NSCLC patients with high DJ-1 level or high sMICA level were lower than those with low DJ-1 or low sMICA level (P < 0.05). Multivariate Cox regression analysis showed that: Lymph node metastasis [O^R = 1.697 (95% CI: 1.421, 1.953) ], degree of differentiation [O^R =1.344 (95% CI: 1.194, 1.648) ], DJ-1 level [O^R = 1.831 (95% CI: 1.652, 2.354) ], and sMICA level [O^R= 2.164 (95% CI: 2.012, 3.956) ] were influential factors for poor prognosis in NSCLC patients (P < 0.05).Conclusion Serum levels of DJ-1 and sMICA are increased in patients with NSCLC, and high levels of DJ-1 and sMICA are associated with invasion metastasis and poor prognosis in patients with NSCLC. DJ-1 and sMICA can be used as serum biological indicators for prognosis assessment of patients with NSCLC.