A Research On Clinical Significance Of Lung Cancer Markers,Such As TLP,about Diagnosis,Drug Resistance And Prognosis In NSCLC

Objective:The date: Lung cancer is the malignant tumor with highest incidence and mortality in the world,w hich is divided into nonsmall-cell lung cancer(NSCLC)and Small Cell Lung Cancer(SCLC),with the most common pathological tissue types being adenocarcinoma and squamous cell carcinomas.Tumor markers are one of the diagnostic methods for the cancer,the specimen in detecting tumor markers being serum and plasma currently.If the bronchoalveoiar Lavage Fluid(BALF),being closer to the lung cancer tissue,is detected as a specimen,a better receiver operating characteristic curve(ROC)area could be gotten.Meanwhile,the rise,reduce and change of tumor markers may suggest some information about prognosis,transfer and resistance of patients with tumor.It is explained that tumor markers are closely related to tumor biological activity.In our study,we take a research on Urine di-acetyl sperimine(Di Ac Spm),Tumor liberated protein(TLP),pro-surfactant protein B(pro-SFTPB),Ubiquitin-protein hydrolase1(UCHL1),carcino-embryonic antigen(CEA),neuron-specific enolase(NSE)and Cytokerantin-19-fragment(CYFRA21-1)to find the clinical significance in prognosis,transfer and resistance of lung cancer.Methods1.Used enzyme-linked immunoassay to detect the concentration of these tumor markers in BALF and serum from 40 patients of lung cancer and 40 patients of lung benign lesions,with a appropriate statistical methods to compare difference.Calculated the area under the ROC curve,diagnostic sensitivity and specificity.Made a analysis on if there was a correlation between tumor concentration and lung cancer classification(adenocarcinoma and squamous carcinoma),lung baseline length,number of target organs distant metastasis and TNM stages.2.35 patients of lung cancer with chemotherapy included 0 case of complete response(CR),15 cases of partial response(PR),13 cases of stable disease(SD)and 7 cases of progressive disease(PD).They were divided into effective group(CR+PR+SD)and invalid group(PD),comparing the concentration of these 7 tumor markers between the two groups and follow-up visiting the information of patients in PD3.Made a 2-years follow-up visiting in 33 cases patients of NSCLC(IIIB or IV),with a Logistic regression analysis on the risk factors of 2 years of mortality.Results1.According to the single factor analysis of variance,in BALF,the concentration of Di Ac Spm?TLP?pro-SFTPB?CEA in patients of lung benign lesions are lower than that in patients of lung cancer(DiAcSpm15.49±6.65 vs 11.67±8.33;TLP 26.26±13.24 vs 18.41±12.36;pro-SFTPB 28.30±18.69 vs 19.05±8.93;CEA17.59±7.18 vs 13.91±7.99 ng/m L),P<0.05.2.Between the concentration of the TLP,CEA in BALF and tumor baseline length,the concentration of pro – SFTPB in serum and the number of target organ metastasis exist the positive correlation(Spearman correlation coefficient were 0.353,0.274 and 0.312),P < 0.05.There are no correlation between the concentration of 7 markers in the two specimen and lung cancer classification(squamous carcinoma,adenocarcinoma),TNM stage,P>0.053.The ROC area of tumor markers in BALF are more than that in serum.4.The ROC area of Di Ac Spm,TLP,pro-SFTPB in BALF and serum,as big as CEA,are more than that of NSE.5.According to the nonparametric test,the concentrations of pro-SFTPB in patients of lung adenocarcinoma from effective group are higher than that from invalid group(The median47.22 vs 29.67 ng/mL),P<0.05.6.According to Logistic regression analysis,“the concentration of DiAcSpm ?UCHL1 ? CEA after chemotherapy”,“complicated with superior vena cava syndrome(SVCS)” and “not stick to standard treatment” are the risk actors of 2 years of mortality in patients of advanced NSCLC.7.According to multiple factors regression analysis,“the concentration of Di Ac Spm after chemotherapy” and “complicated with SVCS” are the risk actors of 2 years of mortality in patients of advanced NSCLC.Results1.In this study,the ROC areas of Di Ac Spm,TLP,pro-SFTPB in BALF and serum are as good as CEA.2.In this study,the ROC areas of all the markers in BALF are bigger than those in serum.3.Between the concentration of the TLP,CEA in BALF and tumor baseline length,the concentration of pro – SFTPB in serum and the number of target organ metastasis exist the positive correlation.4.The lower concentration of pro-SFTPB in serum may suggest drug resistance in paclitaxel and Nida's platinum.5.The concentration of Di Ac Spm ? UCHL1 ? CEA after chemotherapy” and “complicated with SVCS” may suggest poor prognosis.