Significance Of Serum Thymidine Kinase 1 In Diagnosis, Postoperative Monitoring And Chemotherapy Efficacyevaluation Of Non-small Cell Lung Cancer

Purpose: To investigatethe clinical value of serum thymidine kinase 1(s TK1) in patients with primary non-small cell lung cancer and receiving radical operation and chemotherapy.Methods: The levels of serum TK1(s TK1) in 220 cases withnon-small cell lung cancer(NSCLC), 34 cases withlung benign lesion(LBL),and 56 cases of healthy volunteerswere measured byenzyme immunoassay and ot blot enhanced chemiluminescence assay, and analyze its pertinence with clinics. Meanwhile, the levels of serum CEA, CA125, NSE and CYFRA21-1 in these cases were measure to make a comparation.Results :The mean concentration of s TK1 in NSCLC group [1.44(0.76~2.14) p M] was significantly higher than the healthy control group [0.56(0.29~0.95) p M](P<0.05)and the LBL group[0.98(0.55~1.34)p M](P<0.05). There is no obvious difference between the lungbenign lesions group and the health control group(P=0.407). Higher s TK1 level was correlated with histological differentiation, tumor-node-metastasis(TNM) stage, tumor size and metastasisof NSCLC patients(P<0.05), while it was not correlated to any other clinicopathological parameters, such as gender, age or pathological types.As a tumor biomarker for diagnosis of NSCLC, the sensitivity of s TK1 was 32% and the specificity was 94%. But the sensitivity and the specificity of combined detection of s TK1 CEA, CA125, NSE and CYFRA21-1 for the diagnosis of NSCLC was 81% and 78%.The preoperative s TK1, histological differentiation, TNM term is related to recurrence and metastasis of patients who received radical operation(P<0.05). For predicting the recurrence and metastasis of these patients, the corresponding areas under the ROC curve(AUC) is 0.794 for s TK1, with cutoff of 0.94 p M.Relapse-free survival probability of high-level s TK1 group(≥0.94 p M) is obviously lower than the low-level s TK1 group(<0.94 p M)(P<0.05). With combination of preoperative s TK1 level with TNM stage and histological differentiation, the sensibility(95%) of predictingrecurrence and metastasis can be obviously enhanced. The s TK1 decreased significantly one month after surgery(P<0.05), but rised significantly when NSCLC recurred and metastasized(P<0.05). RECIST1.1 was used to evaluate the chemotherapy efficacy. After chemotherapy, s TK1 and CYFRA21-1 levels were significantly decreased in PR group(P<0.05), s TK1,CEA and CYFRA21-1 levels were increased in PD group(P<0.05), and there was no significant difference in concentrations of tumor biomarkers in SD group(P>0.05).The coincidence rate between the results from RECIST1.1 and tumorbiomarkers was 56.9% for s TK1, 53.7% for CEA, 48.8% for CYFRA21-1, and 63% for three markers combined. The coincidence rate of results from three markers combined in PD group was the highest(88.5%).Conclusion: Combining with other serum rumor biomarkers, s TK1 can improve the sensibility of NSCLC’s diagnosis. s TK1 is clinically significant in predicting and diagnosing recurrence and metastasis of NSCLC as well as in evaluating the chemotherapy efficacy.