[1]巫旋钦,陈 庚,贾 砚,等.非小细胞肺癌患者血清anti-CK5，anti-P63 和anti-TTF-1 水平表达及与预后相关性研究[J].现代检验医学杂志,2023,38(06):6-12.[doi:10.3969/j.issn.1671-7414.2023.06.002]
　WU Xuanqin,CHEN Geng,JIA Yan,et al.Study of Serum Anti-CK5, Anti-P63 and Anti-TTF-1 Levels in Patients with Non-Small Cell Lung Cancer and Their Correlation with Prognosis[J].Journal of Modern Laboratory Medicine,2023,38(06):6-12.[doi:10.3969/j.issn.1671-7414.2023.06.002]
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非小细胞肺癌患者血清anti-CK5，anti-P63 和anti-TTF-1 水平表达及与预后相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年06期
页码:
6-12
栏目:
论著
出版日期:
2023-11-15

文章信息/Info

Title:
Study of Serum Anti-CK5, Anti-P63 and Anti-TTF-1 Levels in Patients with Non-Small Cell Lung Cancer and Their Correlation with Prognosis
文章编号:
1671-7414（2023）06-006-07
作者:
巫旋钦; 陈 庚; 贾 砚; 阳 鹏; 陈中良
[中国科学院大学深圳医院（光明）心胸血管外科，广东深圳 518106]
Author(s):
WU Xuanqin; CHEN Geng; JIA Yan; YANG Peng; CHEN Zhongliang
[Department of Cardiothoracic Vascular Surgery, University of Chinese Academy of Sciences, Shenzhen Hospital (Guangming), Guangdong Shenzhen 518106, China]
关键词:
非小细胞肺癌; 细胞角蛋白5 抗体; P63 抗体; 甲状腺转录因子-1 抗体
分类号:
R734.2；R730.43
DOI:
10.3969/j.issn.1671-7414.2023.06.002
文献标志码:
A
摘要:
目的 探讨血清细胞角蛋白5 抗体（cytokeratin 5 antibody，anti-CK5）、P63 抗体（P63 antibody，anti-P63）、甲状腺转录因子-1 抗体（thyroid transcription factor 1 antibody，anti-TTF-1）在非小细胞肺癌（non-small-cell lungcancer，NSCLC）患者中的表达水平以及其与预后的相关性。方法 对2015 年6 月～ 2017 年6 月在中国科学院大学深圳医院接受治疗的80 例NSCLC 患者作为NSCLC 组进行分析，根据预后情况进一步将其分为预后良好（生存）组（n=19）和预后不良（死亡）组（n=61）。并纳入同期80 例肺炎患者为肺炎组（良性病变）和健康体检者（n=80）为对照组。酶联免疫吸附试验法（enzyme linked immunosorbent assay，ELISA）检测血清anti-CK5，anti-P63 和anti-TTF-1 水平；COX 回归分析NSCLC 不良预后的影响因素；受试者工作特征（receiver operating characteristic，ROC）曲线分析血清anti-CK5，anti-P63 和anti-TTF-1 水平对NSCLC 不良预后的预测价值。结果 对照组、肺炎组和NSCLC 组血清中anti-CK5（140.01±46.31 pg/ml，158.79±46.51 pg/ml，178.68±46.44 pg/ml），anti-P63（1.92±0.43 ng/ml，2.17±0.50 ng/ml，2.36±0.52 ng/ml）和anti-TTF-1（2.20±0.44 ng/ml， 2.41±0.42 ng/ml，2.73±0.43 ng/ml）表达水平比较，差异均有统计学意义（F=13.883，16.572，30.809，均P ＜ 0.001）。ROC 结果显示，血清anti-CK5，anti-P63 和anti-TTF-1 水平预测NSCLC 发生的曲线下面积（area under the curve，AUC）分别为0.725（95%CI：0.649 ～ 0.793），0.710（95%CI：0.633 ～ 0.779） 和0.735（95%CI：0.660 ～ 0.802）， 三者联合预测AUC 为0.852（95%CI：0.788 ～ 0.903）， 高于三者单独预测AUC，差异具有统计学意义（Z=2.500，2.795，2.378，P=0.012，0.005，0.021），敏感度和特异度分别为78.75% 和85.00%。死亡组与生存组NSCLC 患者血清中anti-CK5（183.57±47.45 pg/ml vs 163.00±42.66 pg/ml），anti-P63（2.41±0.40 ng/ml vs 2.18±0.39 ng/ml）和anti-TTF-1 水平（2.80±0.46 ng/ml vs 2.51±0.39 ng/ml）比较，差异均有统计学意义（t=3.820，2.201，2.481，均P ＜ 0.05）。COX 回归分析显示，T 分期、N 分期、anti-CK5，anti-P63 和anti-TTF-1 水平均是影响NSCLC 患者预后的独立危险因素（HR=1.443，1.375，1.518，1.771，2.012，均P<0.05）。ROC 结果显示，血清anti-CK5，anti-P63 和anti-TTF-1 水平预测NSCLC 患者预后结局的AUC 分别为0.773（95%CI：0.666 ～ 0.859），0.741（95%CI：0.631 ～ 0.833） 和0.729（95%CI：0.618 ～ 0.822）， 三者联合预测AUC 为0.880（95%CI：0.788 ～ 0.942），高于三者单独预测AUC，差异具有统计学意义（Z=3.834，3.868，3.686，P=0.043，0.032，0.028），敏感度、特异度分别为90.16% 和84.21%。结论 NSCLC 患者血清anti-CK5，anti-P63 和anti-TTF-1 水平升高，与NSCLC 不良预后相关，且联合检测对NSCLC 不良预后的预测价值较高，有一定的临床参考价值。
Abstract:
Objective To investigate the expression levels of serum cytokeratin 5 antibody (anti-CK5), P63 antibody (anti-P63) and thyroid transcription factor 1 antibody (anti-TTF-1) in patients wiith non-small cell lung cancer (NSCLC) and their correlation with prognosis. Methods Eighty patients with NSCLC who were treated in University of Chinese Academy of Sciences Shenzhen Hospital from June 2015 to June 2017 were collected as the NSCLC group, according to the prognosis,they were further divided into good prognosis (survival) group of 19 cases and poor prognosis (death) group of 61 cases. In addition, 80 patients with pneumonia during the same period were included as the pneumonia group (benign lesions), while 80 health examinees in the same period were included as the control group. The levels of anti-CK5, anti-P63 and anti-TTF-1 in serum were detected by enzyme linked immunosorbent assay (ELISA). COX regression was applied to analyze the influencing factors of poor prognosis of NSCLC，receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum levels of anti-CK5, anti-P63 and anti-TTF-1 for poor prognosis of NSCLC. Results Serum levels of anti-CK5 (140.01±46.31 pg/ml, 158.79±46.51 pg/ml, 178.68±46.44 pg/ml), anti-P63 (1.92±0.43 ng/ml, 2.17±0.50 ng/ml, 2.36±0.52 ng/ml), and anti-TTF-1 (2.20±0.44 ng/ml，2.41±0.42 ng/ml，2.73±0.43 ng/ml) expression in the control group, pneumonia group, and NSCLC group were compared, and the differences were statistically significant (F=13.883, 16.572, 30.809, all P<0.001). ROC results showed that the AUC of serum anti-CK5, anti-P63, and anti-TTF-1 levels to predict the occurrence of NSCLC was 0.725 (95% CI: 0.649 ～ 0.793), 0.710 (95% CI: 0.633 ～ 0.779) and 0.735 (95% CI: 0.660 ～ 0.802), respectively, The area under the curve (AUC) predicted by the combination of the three was 0.852 (95% CI: 0.788~0.903), which was higher than the AUC predicted by the three alone, and the difference was statistically significant (Z=2.500, 2.795, 2.378, P=0.012, 0.005, 0.021), and the sensitivities and specificities were 78.75%，85.00% ，respectively. The differences in serum levels of anti-CK5 (183.57±47.45 pg/ml vs 163.00±42.66 pg/ml), anti-P63(2.41±0.40 ng/ml vs 2.18±0.39 ng/ml), and anti-TTF-1(2.80±0.46 ng/ml vs 2.51±0.39 ng/ml) in patients with NSCLC in the death and survival groups were statistically significant (t=3.820， 2.201，2.481, all P<0.05). According to COX regression analysis, T stage, N stage, anti-CK5, anti-P63 and anti-TTF-1 levels were independent risk factors affecting the prognosis of NSCLC patients (HR=1.443, 1.375, 1.518, 1.771, 2.012, all P<0.05). ROC results showed that the AUC of serum anti-CK5, anti-P63 and anti-TTF-1 levels in predicting the prognosis of NSCLC patients was 0.773 (95%CI: 0.666 ～ 0.859), 0.741 (95%CI: 0.631 ～ 0.833) and 0.729 (95%CI: 0.618 ～ 0.822), respectively, the AUC of the combined prediction was 0.880(95%CI:0.788 ～ 0.942), which was higher than the AUC predicted by the three alone, and the difference was statistically significant (Z=3.834, 3.868, 3.686, P=0.043, 0.032, 0.028)，in which the sensitivity and specificity were 90.16% and 84.21% respectively. Conclusion Elevated serum anti-CK5, anti-P63 and anti-TTF-1 levels in NSCLC patients correlate with poor prognosis of NSCLC, and the combined assay has a high predictive value for poor prognosis of NSCLC, which has some clinical reference value.

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备注/Memo

备注/Memo:
基金项目：深圳市光明区软科学研究项目（编号：2021R01030）：肿瘤相关抗原自身抗体水平与非小细胞肺癌早期诊断及预后的关系研究。
作者简介：巫旋钦（1983-），男，本科，主治医师，主要从事肺部肿瘤微创治疗相关研究，E-mail：Wuxu0528@163.com。
通讯作者：陈中良（1963-），男，主任医师，E-mail：2916491892@qq.com。
更新日期/Last Update: 2023-11-15