2024 年第 1 期 第 19 卷

血清血管细胞黏附因子1和三叶因子3水平与晚期非小细胞肺癌化疗效果及预后的关系

The relationship between serum vascular adhesion molecule 1, trefoil factor 3 levels and chemotherapy efficacy and prognosis in advanced non-small cell lung cancer

作者：王昕炜 方瑛 王欣

英文作者：Wang Xinwei Fang Ying Wang Xin

单位：江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院肿瘤内科，南京210009

英文单位：Department of Oncology Jiangsu Cancer Hospital Jiangsu Institute of Cancer Research the Affiliated Cancer Hospital of Nanjing Medical University Nanjing 210009 China

关键词：晚期非小细胞肺癌；细胞间黏附分子1；三叶因子3；化疗；预后

英文关键词：Advancednon-smallcelllungcancer;Vascularadhesionmolecule1;Trefoilfactor3;Chemotherapy;Prognosis

• 摘要：

• 目的  研究血管细胞黏附因子1(VCAM1)、三叶因子3（TFF3）水平与晚期非小细胞肺癌(NSCLC)患者化疗效果及预后的关系。方法  选取2019年2月至2021年2月江苏省肿瘤医院收治的112例接受铂类化疗初治的晚期NSCLC患者为观察组，另选取同期体检健康的70例受试者为对照组。检测受试者血清VCAM1、TFF3水平。根据化疗结束后的效果，将观察组患者分为化疗有效组和化疗无效组。随访1年，比较不同血清VCAM1、TFF3表达水平晚期NSCLC患者生存预后差异。采用多因素Cox回归模型分析影响晚期NSCLC患者生存预后的因素。结果  观察组血清VCAM1、TFF3水平均高于对照组［（227±24）μg/L比（79±13）μg/L、（1.59±0.37）μg/L比（0.47±0.14）μg/L］，差异均有统计学意义（均P<0.001）。晚期NSCLC患者血清VCAM1、TFF3水平与肿瘤分化程度及TNM分期有关（均P<0.05）。化疗无效组患者血清VCAM1、TFF3水平均高于化疗有效组，差异均有统计学意义（均P<0.001）。VCAM1高表达组1年总体生存率为26.9%（14/52），VCAM1低表达组为55.0%（33/60），组间比较差异有统计学意义（Log-rank χ2=12.181，P＜0.001）。TFF3高表达组1年总体生存率为27.8%（15/54），TFF3低表达组为55.2%（32/58），组间比较差异有统计学意义（Log-rank χ2=14.146，P＜0.001）。多因素Cox回归分析结果显示，肿瘤低分化程度、TNM分期Ⅳ期、VCAM1高表达、TFF3高表达是晚期NSCLC患者不良预后的独立危险因素（均P＜0.001）。结论  晚期NSCLC患者血清VCAM1、TFF3水平升高，二者与不良临床病理特征、化疗效果有关。

• Objective  To investigate the relationship between vascular adhesion molecule 1 (VCAM1), trefoil factor 3 (TFF3) levels and chemotherapy efficacy and prognosis in patients with advanced non-small cell lung cancer (NSCLC). Methods  Totally 112 advanced NSCLC patients who received chemotherapy treatment in Jiangsu Cancer Hospital from February 2019 to February 2021 were selected as the observation group. Another 70 healthy individuals who underwent physical examinations during the same period were selected as the control group. Serum VCAM1 and TFF3 levels of subjects were detected. According to the effect after chemotherapy, patients in the observation group were divided into the chemotherapy effective group and the chemotherapy ineffective group. Follow-up for 1 year, the differences in survival prognosis among patients with advanced NSCLC with different levels of serum VCAM1 and TFF3 expression were compared. Multivariate Cox regression analysis was used to analyze factors affecting the survival prognosis of advanced NSCLC patients. Results  The serum levels of VCAM1 and TFF3 in the observation group were higher than those in the control group ［（227±24）μg/L vs （79±13）μg/L,（1.59±0.37）μg/L vs （0.47±0.14）μg/L］(both P＜0.001). The serum levels of VCAM1 and TFF3 in advanced NSCLC patients were related to tumor differentiation and TNM staging (all P<0.05). The serum levels of VCAM1 and TFF3 in the chemotherapy ineffective group were higher than those in the chemotherapy effective group (both P<0.001). The overall 1-year survival rate was 26.9%(14/52) in the VCAM1 high expression group, and 55.0%(33/60) in the VCAM1 low expression group, and the difference was statistically significant (Log-rank χ2=12.181, P<0.001). The overall 1-year survival rate was 27.8% (15/54) in the TFF3 high expression group, and 55.2% (32/58) in the TFF3 low expression group, and the difference was statistically significant (Log-rank χ2=14.146, P<0.001). Multivariate Cox regression analysis showed that low tumor differentiation, TNM staging Ⅳ, high expression of VCAM1, and high expression of TFF3 were independent risk factors affecting the poor survival prognosis of advanced NSCLC patients. Conclusion  Elevated serum VCAM1 and TFF3 levels in patients with advanced NSCLC are associated with adverse clinical pathological features and chemotherapy efficacy.