Predictive and prognostic value of preoperative serum tumor markers in resectable adenosqamous lung carcinoma.
Predictive and prognostic value of preoperative serum tumor markers in resectable adenosqamous lung carcinoma.
复制标题
术前血清肿瘤标志物对可切除腺鳞癌的预测及预后价值
DOI：
10.18632/oncotarget.11703
复制
发表时间：
2016-10-04
期刊：
影响因子：
--
通讯作者：
Jiang R
中科院分区：
文献类型：
--
作者：
Zhi Q;Wang Y;Wang X;Yue D;Li K;Jiang R
背景：腺鳞癌是一种罕见的侵袭性肺癌。肺腺鳞癌术前血清肿瘤标志物和EGFR突变频率的预后和预测价值尚不清楚。方法回顾性分析2008年至2013年106例肺腺鳞癌根治术患者的临床资料和手术标本。分析血清肿瘤标志物水平与EGFR突变以及生存参数之间的相关性，并确定预后因素。结果106例肺腺鳞癌患者中，29例（27.4%）携带EGFR突变。经单因素分析，晚期临床分期（无病生存期[DFS] P = 0.009;总生存期[OS] P = 0.046），肿瘤尺寸较大（DFS P = 0.001; OS P = 0.002），区域淋巴结转移高NSE水平（P = 0.002; P < 0.001）和高TMI（P = 0.009）与预后差显著相关。多因素分析显示NSE（P = 0.014）是DFS的独立预测因子，NSE（P = 0.001）和TMI（P = 0.038）是OS的独立预后因子。术前NSE水平升高和TMI是不良预测和预后指标。
Background Adenosquamous carcinoma is a rare and aggressive form of lung cancer. The prognostic and predictive value of preoperative serum tumor markers and frequency of EGFR mutations in adenosquamous lung carcinoma are unclear. Methods We retrospectively analyzed data and samples collected from 106 radically resected adenosquamous lung carcinoma patients with pathological stage I-IIIA between 2008 and 2013. Correlations between serum tumor marker levels and EGFR mutations as well as survival parameters were analyzed and prognostic factors were identified. Results Of the 106 adenosquamous lung carcinoma patients, 29 (27.4%) harbored EGFR mutations. By univariate analysis, advanced clinical stage (P = 0.009 for disease-free survival [DFS]; P = 0.046 for overall survival [OS]), larger tumor size (P = 0.001 for DFS; P = 0.002 for OS), regional lymph node metastasis (P = 0.024 for DFS; P = 0.030 for OS), higher NSE level (P = 0.002 for DFS; P < 0.001 for OS), and higher TMI (tumor marker index) (P = 0.009 for OS) were significantly correlated with a worse prognosis. By multivariate analysis, NSE (P = 0.014) was confirmed as independent predictor for DFS, while NSE (P = 0.001) and TMI (P = 0.038) were independent prognostic factors for OS. Conclusion Adenosquamous lung carcinoma is an aggressive malignancy with relatively high EGFR mutation frequency. Elevated preoperative NSE level and TMI are adverse predictive and prognostic indicators.