血清TSP-1水平对非小细胞肺癌预后的临床价值

发布时间：2018-04-04 15:10

本文选题：TSP-1　切入点：非小细胞肺癌　出处：《皖南医学院》2017年硕士论文

【摘要】：目的:肺癌大部分为非小细胞肺癌,发病率高,确诊时多为晚期。有研究指出血小板反应蛋白-1(TSP-1)在肺癌进展过程中有不同程度表达,具体表现在抑制细胞粘附,抑制新生血管的生长及抑制肿瘤生长等方面。本研究通过检测患者血清TSP-1浓度在非小细胞肺癌(NSCLC)患者化疗前后的表达程度差异,探讨其是否能对非小细胞肺癌预后提供临床评估。方法:实验组选自2015年10月1日至2016年10月31日,在皖南医学院第一附属医院呼吸内科二病区经病理确诊为原发性非小细胞肺癌并化疗治疗病人48例。患者化疗方案是依据NCCN指南推荐,综合患者自身情况的进行个体化治疗。健康对照组来自同期第一附属医院体检中心健康体检者(经伦理委员会批准)20例。通过检测健康组及实验组肺癌患者首次化疗前、第三次化疗前、第五次化疗前的血清TSP-1的浓度值(具体操作是抽取病人入院第二天清晨空腹静脉血),于化疗4周期结束后评估化疗疗效,观察化疗疗效与TSP-1浓度之间是否存在关联。收集资料具体内容包括年龄、性别、吸烟史、血常规、血凝常规、肿瘤标记物、病理类型、体力状况评分、病情评估资料、化疗方法等。结果:一、将实验组和对照组血小板计数进行组间差异比较发现P值大于0.05,实验组血凝常规完全正常和不完全正常的患者TSP-1浓度值差异无意义。二、对照组与实验组TSP-1浓度比较,NSCLC患者首次化疗前、第三次化疗前、第五次化疗前血清TSP-1浓度显著低于健康对照组(P0.01);三、按照患者病情评估资料将实验组具体分为CR(完全缓解,0例)组、PR(部分缓解,20例)组、SD(病情稳定,18例)组、PD(病情进展,10例)组。比较三组在首次化疗前、第三次化疗前、第五次化疗前血清TSP-1浓度,发现PR组TSP-1浓度呈现递增趋势(P0.01),SD组化疗前后TSP-1浓度差异变化不明显(P0.05),PD组TSP-1浓度值呈现递减趋势(P0.01);比较首次化疗前、第三次化疗前、第五次化疗前的PR组、SD组、PD组差异,发现首次化疗前、第三次化疗前TSP-1血清浓度差异P值大于0.05,第五次化疗前TSP-1浓度三组差异P值小于0.01。结论:NSCLC血清中TSP-1浓度明显低于正常人群,其浓度的升高与降低趋势与患者化疗疗效评价一致。血清TSP-1浓度可为NSCLC的预后提供临床价值。
[Abstract]:Objective: the majority of lung cancer is non-small cell lung cancer, the incidence is high, the diagnosis is more advanced.The purpose of this study was to detect the expression of serum TSP-1 in patients with non-small cell lung cancer (NSCLC) before and after chemotherapy, and to explore whether it could provide a clinical evaluation for the prognosis of NSCLC.Methods: from October 1, 2015 to October 31, 2016, 48 patients with primary non-small cell lung cancer were pathologically diagnosed as primary non-small cell lung cancer and treated with chemotherapy in Department of Respiratory Medicine, the first affiliated Hospital of Southern Anhui Medical College.Patient chemotherapy regimen is based on the NCCN guidelines, comprehensive individual treatment of their own conditions.The healthy control group came from the first affiliated hospital in the same period (20 cases were approved by the Ethics Committee).Before the first chemotherapy and the third chemotherapy, the lung cancer patients in the healthy group and the experimental group were detected.The concentration of serum TSP-1 before the fifth chemotherapy (the operation was to extract the fasting venous blood of the patient on the second day after admission, to evaluate the effect of chemotherapy after 4 cycles of chemotherapy, and to observe whether there was a correlation between the curative effect of chemotherapy and the concentration of TSP-1.The data included age, sex, smoking history, blood routine, hemagglutination routine, tumor marker, pathological type, physical status score, disease evaluation data, chemotherapy methods and so on.Results: first, the difference of platelet count between the experimental group and the control group showed that P value was greater than 0.05, and the TSP-1 concentration of the patients with complete normal and incomplete hemagglutination in the experimental group had no significance.2. The concentration of serum TSP-1 in the control group and the experimental group was significantly lower than that in the control group before the first chemotherapy, before the third chemotherapy, and before the fifth chemotherapy.According to the evaluation data of the patients, the experimental group was divided into two groups: group R (0 cases of complete remission) and group P (20 cases of partial remission), group D (18 cases of stable disease) and group D (10 cases of disease progression).The levels of serum TSP-1 were compared before the first chemotherapy, before the third chemotherapy and before the fifth chemotherapy in the three groups.It was found that before the first chemotherapy, the difference of TSP-1 serum concentration was greater than 0.05 before the third chemotherapy, and the difference P value of the three groups before the fifth chemotherapy was less than 0.01.Serum TSP-1 concentration can provide clinical value for prognosis of NSCLC.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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