| 华 红,付爱锋,戴露婵,刘明霞,逄 倩.血清ProGRP、TSGF与EGFR突变阳性晚期非小细胞肺癌患者疗效和预后的关系[J].,2024,(4):701-707 |
| 血清ProGRP、TSGF与EGFR突变阳性晚期非小细胞肺癌患者疗效和预后的关系 |
| Relationship between Serum ProGRP, TSGF and Outcome and Prognosis of Patients with EGFR Mutation-Positive Advanced Non-small Cell Lung Cancer |
| 投稿时间：2023-10-23 修订日期：2023-11-17 |
| DOI：10.13241/j.cnki.pmb.2024.04.020 |
| 中文关键词: ProGRP TSGF 晚期非小细胞肺癌 EGFR突变 疗效 预后 |
| 英文关键词: ProGRP TSGF Advanced non-small cell lung cancer EGFR Mutation Efficacy Prognosis |
| 基金项目:山东省自然科学基金面上项目（编号：ZR202103030420） |
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| 中文摘要: |
| 摘要 目的：探讨血清胃泌素前体释放肽（ProGRP）、肿瘤特异性生长因子（TSGF）与表皮生长因子受体（EGFR）突变阳性晚期非小细胞肺癌（NSCLC）患者疗效和预后的关系。方法：选取2017年1月～2020年1月在青岛市中医医院、青岛市红岛人民医院、青岛市交运老年病医院、青岛市胸科医院接受EGFR-酪氨酸激酶抑制剂治疗的EGFR突变阳性晚期NSCLC患者95例。所有患者根据疗效情况分为有效组和无效组，采用化学发光法和速率法检测有效组与无效组血清ProGRP、TSGF的差异。随访3年统计总生存率和中位生存时间，根据血清ProGRP（365.73±14.35）pg/mL、TSGF（147.88±27.59）U/mL均值将EGFR突变阳性晚期NSCLC患者分为高ProGRP组（≥365.73 pg/mL，41例）、高TSGF组（≥147.88 U/mL，46例）、低ProGRP组（＜365.73 pg/mL，54例）、低TSGF组（＜147.88 U/mL，49例）。Kaplan-Meier法绘制高/低血清ProGRP、TSGF水平EGFR突变阳性晚期NSCLC患者的生存曲线。并根据预后情况将EGFR突变阳性晚期NSCLC患者分为存活组（56例）、死亡组（39例）。单因素和多因素Cox回归分析影响EGFR突变阳性晚期NSCLC患者预后的因素，受试者工作特征（ROC）曲线分析血清ProGRP、TSGF水平对EGFR突变阳性晚期NSCLC患者预后的预测价值。结果：治疗6周后，无效组血清ProGRP、TSGF水平高于有效组（P＜0.05）。随访期间无失访病例，95例EGFR突变阳性晚期NSCLC患者的客观缓解率为70.53%（67/95），3年总生存率为41.05%（39/95），中位生存时间16.00个月。Kaplan-Meier曲线分析显示，高ProGRP组、高TSGF组总生存率和中位生存时间低于低ProGRP组、低TSGF组（P＜0.05）。单因素和多因素Cox回归分析显示，TNM分期Ⅳ期、低分化、ProGRP升高、TSGF升高为影响EGFR突变阳性晚期NSCLC患者预后的独立危险因素（P＜0.05）。ROC曲线分析显示，血清ProGRP、TSGF水平联合预测EGFR突变阳性晚期NSCLC患者死亡的曲线下面积为0.879，大于血清ProGRP、TSGF水平单独预测的0.765、0.773。结论：血清ProGRP、TSGF水平升高与EGFR突变阳性晚期NSCLC患者疗效和预后密切相关，血清ProGRP、TSGF水平联合检测对其有较高的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum progastrin-releasing peptide (ProGRP), tumor-specific growth factor (TSGF) and the efficacy and prognosis of patients with epidermal growth factor receptor (EGFR) mutation-positive advanced non-small cell lung cancer (NSCLC). Methods: A total of 95 EGFR mutation positive advanced NSCLC patients treated with EGFR-tyrosine kinase inhibitors in Qingdao Traditional Chinese Medicine Hospital, Qingdao Hongdao People's Hospital, Qingdao Jiaoyun Geriatric Hospital, Qingdao Chest Hospital from January 2017 to January 2020 were selected. All patients were divided into effective and ineffective groups according to the efficacy and the difference in serum ProGRP and TSGF between the valid and ineffective groups was detected by chemiluminescence and rate methods. EGFR mutation positive patients and median survival time, according to the mean of serum ProGRP (365.73±14.35) pg/mL, TSGF (147.88±27.73 pg/mL, 41 patients), high TSGF (147.88 U, 46 patients), low ProGRP (<365.73 pg/mL, 54 patients), and low TSGF (<347.88 U/mL, 49 patients). Survival curves of EGFR mutation-positive advanced NSCLC patients with high/low serum ProGRP and TSGF levels were plotted using the Kaplan-Meier method. And the patients with EGFR mutation-positive advanced NSCLC were divided into death group (56 cases) and survival group (39 cases) according to the prognosis. Factors affecting the prognosis of EGFR mutation-positive advanced NSCLC patients were analyzed using univariate and multivariate Cox regression, and the predictive value of serum ProGRP and TSGF levels in EGFR mutation-positive advanced NSCLC patients was analyzed by using receiver operating characteristic (ROC) curves. Results: After 6 weeks of treatment, the serum ProGRP and TSGF levels were higher in the ineffective group than in the effective group (P<0.05). There were no cases lost to follow-up during follow-up, the objective response rate of 95 EGFR mutation-positive advanced NSCLC was 70.53% (67/95), a 3-year overall survival rate of 41.05% (39/95), and a median survival time of 16.00 months. The Kaplan-Meier curve analysis showed that the overall survival rate and median survival time in the high ProGRP and high TSGF groups were lower than those in the low ProGRP and low TSGF groups (P<0.05). Univariate and multivariate Cox regression analysis showed that, TNM stage IV, poor differentiation, elevated ProGRP and elevated TSGF were independent risk factors affecting the prognosis of patients with EGFR mutation-positive advanced NSCLC(P＜0.05). ROC curve analysis showed that, the area under the curve of serum ProGRP and TSGF levels in predicting the death of patients with EGFR mutation-positive advanced NSCLC was 0.879, which was greater than 0.765 and 0.773 predicted by serum ProGRP and TSGF levels alone. Conclusion: Elevated serum ProGRP and TSGF levels are closely related to the efficacy and prognosis of patients with EGFR mutation-positive advanced NSCLC, and the combined detection of serum ProGRP and TSGF levels has a high predictive value for them. |
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