摘要
目的探讨血清可溶CD146(soluble CD146,s CD146)判定肺腺癌表皮生长因子受体-酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI)耐药的价值。方法选取2016年1月至2016年12月在郑州大学人民医院确诊的肺腺癌EGFR敏感患者144例,根据服用TKI药物时间的不同将其分为未服药组(31例)、服药治疗1～3个月组(25例)、服药治疗4～6个月组(19例)、服药治疗7～12个月组(25例)、服药治疗耐药组(24例)以及服药治疗超过1年未耐药组(20例)。采用ELISA和电化学发光法检测患者血清s CD146、癌胚抗原(carcinoembryonic antigen,CEA)和神经元特异性烯醇化酶(neuron-specific enolase,NSE)水平,比较血清s CD146、CEA、NSE在不同服药时间段的差异,同时分析血清s CD146与肿瘤标志物CEA、NSE以及肿瘤临床相关指标(年龄、性别、肿瘤分期、有无远处转移、肿瘤直径、病灶数量)的关系。结果未服药组血清s CD146水平最低,与其他所有组比较差异有统计学意义(均P<0.05);服药治疗1～3个月组血清s CD146水平最高(即服药初期水平最高),随着服药时间的延长且在未耐药前血清s CD146水平有下降趋势但差异无统计学意义(P>0.05)。耐药组s CD146水平较所有服药未耐药组水平有明显下降趋势(均P<0.05),但仍显著高于未服药组(P<0.05)。服药治疗超过1年未耐药组血清s CD146水平与服药治疗在1年内未耐药组水平相当(P>0.05),且显著高于未服药组和耐药组水平(均P<0.05)。六组间的血清CEA水平差异无统计学意义(P>0.05)。血清NSE水平4～6个月组与7～12个月组差异有统计学意义(P<0.05),但均在正常参考值范围内,其余组差异无统计学意义(均P>0.05)。血清s CD146与血清CEA、NSE无相关性,与性别、年龄、肿瘤分期、肿瘤直径、病灶数量也均无相关性(均P>0.05),与有无远处转移有相关性(P<0.05)。结论 s CD146可能参与了TKI杀伤肿瘤细胞的作用机�
ObjectiveTo investigate the value of serum soluble CD146 （sCD146） in determining acquired epidermal growth factor receptor-tyrosine kinase inhibitor （EGFR-TKI） resistance in lung adenocarcinoma.MethodsA total of 144 lung adenocarcinoma EGFR sensitive patients in People’s Hospital of Zhengzhou University diagnosed from January 2016 to December 2016 were recruited in the study. According to the different time of taking drugs, the patients were divided into a non-medication group （31 cases）, a 1 to 3 month treatment group （25 cases）, a 4 to 6 month treatment group （19 cases）, a 7 to 12 month treatment group （25 cases）, a drug-resistant group （24 cases）, and a nonresistant group up to 1 year of treatment （20 cases）. The serum levels of sCD146, carcinoembryonic antigen （CEA） and neuron-specific enolase （NSE） were measured by ELISA and chemiluminescence and compared between different period of medication. The relationship of serum sCD146 with tumor markers （CEA, NSE） and tumor related clinical parameters （age, gender, tumor stage, metastasis, tumor diameter, number of the lesions） were analyzed.ResultsThe serum sCD146 level was minimum in the non-medication group that did not receive pioglitazone treatment, highest in the 1 to 3 month treatment group （early treatment period）, and declined with duration of medication until resistance occurred without significant difference （P〉0.05）. The level of sCD146 of the drug-resistant group was significantly lower than that of all nonresistant groups, with significant difference （allP〈0.05）, but still higher than that of the non-medication group （P〈0.05）. The serum sCD146 levels in the nonresistant patients with medication over 1 year and within 1 year were similar （P〉0.05）, and significantly higher than the non-medication group and drug-resistance group （allP〈0.05）. The serum CEA levels did not differ significantly between 6 groups （P〉0.05）. The serum NSE level of the 4 to 6 month treatment
作者
刘畅
马利军
LIU Chang, MA Lijun(Department of Critical and Respiratory Medicine, People＇s Hospital of Zhengzhou University, zhengzhou, Henan 450000, P. R. Chin)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2018年第2期155-160,共6页
Chinese Journal of Respiratory and Critical Care Medicine
基金
河南省人社部留学人员科技活动择优资助项目(2013227)
河南省科技厅基础与前沿项目(152300410148)
