外周血ctDNA及Survivin预测NSCLC预后的临床研究

目的探讨外周血中循环肿瘤DNA(ctDNA)与凋亡抑制蛋白存活素(Survivin)预测非小细胞肺癌(NSCLC)预后的临床应用价值。方法以138例NSCLC患者为研究组,以56例健康志愿者为对照组,根据受试者工作特征(ROC)曲线,判定ctDNA及Survivin mRNA的界限值,分析外周血ctDNA、Survivin表达对NSCLC预后的预测作用。结果研究组ctDNA与Survivin mRNA表达水平均高于对照组(P<0.05)。ctDNA和Survivin mRNA的最佳截点分别为17.23 ng/mL、5.34×10⁵ copies/mL。术后是否化疗、p-TNM分期、ctDNA与Survivin mRNA表达水平均与患者生存时间有关。ctDNA≥17.23 ng/mL、Survivin mRNA≥5.34×10⁵ copies/mL患者与ctDNA<17.23 ng/mL、Survivin mRNA<5.34×10⁵ copies/mL患者生存曲线差异有显著性(P<0.05)。p-TNM分期、ctDNA与Survivin mRNA表达情况均是影响NSCLC预后的独立指标(P<0.05)。结论NSCLC患者外周血ctDNA及Survivin表达水平较高,是影响NSCLC患者预后的危险因素,可作为预后预测的分子标志物。

Clinical study of ctDNA and Survivin in predicting prognosis of NSCLC

Objective To investigate the clinical value of circulating tumor DNA(ctDNA)and the apoptosis inhibitor survivin(Survivin)in predicting the prognosis of non-small cell lung cancer(NSCLC).Methods 138 NSCLC patients were taken as the study group,and 56 healthy volunteers were taken as the control group.According to the receiver operating characteristic(ROC)curve,the threshold value of ctDNA and Survivin mRNA was determined,and the predictive effect of ctDNA and Survivin expression in peripheral blood on the prognosis of NSCLC was analyzed.Results The expression levels of ctDNA and Survivin mRNA in the study group were higher than those in the control group(P<0.05).The optimal cut-off points for ctDNA and Survivin mRNA were 17.23 ng/mL and 5.34×10⁵ copies/mL.Postoperative chemotherapy,p-TNM staging,ctDNA,and Survivin mRNA expression levels were related to the survival time of patients.The survival curves of patients with ctDNA≥17.23 ng/mL and Survivin mRNA≥5.34×10⁵ copies/mL were significantly different from those with ctDNA<17.23 ng/mL and Survivin mRNA<5.34×10⁵ copies/mL(P<0.05).p-TNM staging,ctDNA,and Survivin mRNA expression were all independent indicators affecting the prognosis of NSCLC patients(P<0.05).Conclusion The expression levels of ctDNA and Survivin in peripheral blood of NSCLC patients were higher,and they were risk factors affecting the prognosis of NSCLC patients and can be used as molecular markers for prognosis prediction.