Tumoral CD10 expression correlates with high-grade histology and increases risk of recurrence in patients with stage I lung adenocarcinoma

ObjectiveCD10 (neutral endopeptidase) is expressed in various normal and tumor cells, and its biological function can be controlled through enzymatic activity and signaling pathways. We investigated whether CD10 expression predicted disease recurrence and whether it correlated with histologic subtypes of stage I lung adenocarcinoma.Materials and methodsWe reviewed tumor slides of resected pathologic stage I lung adenocarcinomas (1995–2009). Tumors were classified according to the IASLC/ATS/ERS classification. CD10 immunohistochemistry was performed using tissue microarrays (n = 915). We combined the intensity (0–3) and distribution scores (0–2) for CD10 to create a total score (0–5). Risk of recurrence was estimated using competing risks methods.ResultsIn the training cohort (n = 313), risk of recurrence of patients with high tumoral CD10 (score > 1, n = 57) was significantly higher (5-year cumulative incidence of recurrence [CIR], 37%) than in those with low CD10 (score ≤ 1; n = 256; 5-year CIR, 16%; P < 0.001); this finding was confirmed in the validation cohort (n = 602, P = 0.036). High tumoral CD10 was associated with higher risk of recurrence in acinar (P = 0.007) and papillary predominant tumors (P = 0.022). High tumoral CD10 was most frequently identified in micropapillary predominant (41%) and solid predominant tumors (34%). On multivariate analysis of intermediate-grade tumors, high tumoral CD10 remained a significant independent risk factor of recurrence (hazard ratio, 1.88; P = 0.025).ConclusionIn stage I lung adenocarcinoma, tumoral CD10 correlated with high-grade histology and was an independent predictor of recurrence in intermediate-grade tumors.     

Clinical application of serum tumor associated material (TAM) from non-small cell lung cancer patients

Objective: To explore the associations of serum tumor associated material (TAM) with other common tumormarkers like carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen19-9(CA19-9) and its clinical application in non-small cell lung cancer (NSCLC) patients. Methods: A total of 87patients were enrolled into this study, all with histologically or cytologically confirmed NSCLC. With the methodof chemical colorimetry, the level of TAM was determined and compared, while chemiluminescence was usedto measure the levels of common tumor markers. Results: The level of TAM decreased after chemotherapycompared with before chemotherapy when CT or MRI scans showed disease control. Furthermore, it increasedwhen disease progessed and there was no statistically significant difference in monitoring of TAM and commontumor markers (P>0.05). Conclusions: Detecting TAM in NSCLC patients has a higher sensitivity and specificity,so it can be used as an indicator for clinical monitoring of lung cancer chemotherapy.     

Factors associated with local and distant recurrence and survival in patients with resected nonsmall cell lung cancer

BACKGROUND:

This study assessed the impact of surgical, histopathologic and patient‐related factors on the risks of local and distant recurrence and overall survival for patients with stages I through IIIA nonsmall cell lung carcinoma (NSCLC) undergoing definitive resection with or without adjuvant chemotherapy.

METHODS:

This study included 373 consecutive patients treated between 2000 and 2005 who did not receive adjuvant or neoadjuvant radiotherapy, had at least 3 months of follow‐up, and did not have a history of other cancers within 5 years of the diagnosis of their NSCLC. Of these, 52% had pathologic stage IA disease, 30% had stage IB, 5% had stage IIA, 8% had stage IIB and 5% had stage III disease. Forty‐four patients received chemotherapy.

RESULTS:

The median follow‐up was 33 months. Local failure rates at 2 years, 3 years, and 5 years were 16%, 22%, and 32%, respectively; distant recurrence rates were 13%, 15%, and 21%, respectively. Multivariable analysis revealed that local recurrence was significantly associated with the presence of lymphatic or vascular invasion (LVI), the use of chemotherapy, and having diabetes; distant recurrence was significantly higher in patients with nonsquamous cell histology, those undergoing pneumonectomy, and those with more advanced TNM stage. Survival was significantly associated with age, history of myocardial infarction, performance of a pneumonectomy, histology, LVI, and the number of positive N1 lymph nodes.

CONCLUSIONS:

Local recurrence was the predominant type of failure in this series. Patient with diabetes or LVI may benefit from close surveillance and aggressive therapy of asymptomatic local recurrences, especially when chemotherapy is given in addition to surgery. Cancer 2009. © 2009 American Cancer Society.     

多基因表达对IIIA期非小细胞肺癌术后转移及生存期的影响

目的前瞻性探讨抑癌基因p53,癌基因K-ras、HER2, 血管内皮生长因子(VEGF),表皮生长因子受体(EGFR),粘连因子CD44,金属蛋白酶MMP9等蛋白表达对ⅢA期非小细胞肺癌(NSCLC)术后复发转移和生存期的影响.方法采用免疫组织化学方法检测32例ⅢA期非小细胞肺癌手术标本中上述蛋白表达.结果 p53、K-ras、VEGF、EGFR、CD44、MMP9和HER2蛋白表达率分别为62.5%(20/32)、34.3%(11/32)、25.0%(8/32)、46.9%(15/32)、78.1% (25/32)、50%(16/32)和43.8%(14/32).K-ras,EGFR蛋白表达与疾病进展时间(time to progression,TTP)有关(P=0.030, P=0.008).多变量Cox回归分析,K-ras,HER2蛋白表达是影响生存期的独立影响因素.Kaplan-M 生存分析显示K-ras,HER2 阳性组生存期明显短于阴性组(P=0.042,P=0.039).结论对于ⅢA期NSCLC,上述7种因子阳性表达率很高.K-ras,EGFR蛋白表达阳性患者术后更易发生远处转移, K-ras,HER2表达是影响生存期的独立影响因素.     

临床Ⅰ和Ⅱ期肺癌纵隔淋巴结微小转移灶的研究

目的 研究早期肺癌患者纵隔淋巴结内癌细胞微小转移的发生发展规律及其临床意义。方法 收集32例临床分期为Ⅰ期或Ⅱ期且未经任何术前治疗的肺癌患者的181枚纵隔淋巴结,每枚淋巴结于两个不同层面切取冰冻切片,用抗上皮细胞抗原的Ber-Ep4抗体进行免疫组化染色,同时行HE染色进行对照,观察早期肺癌纵隔淋巴结内微小转移的情况。结果 15例患者(46．9％)的2l枚(11．6％)常规病理石蜡切片HE染色阴性的纵隔淋巴结,经Ber-Ep4免疫组化染色发现有微小癌细胞转移灶,其中6例患者冰冻切片HE染色也发现有微小转移灶。术后常规病理检查确定为N0、N1、N2的患者分别为19,6,7例,Ber-Ep4免疫组化染色后微小转移灶阳性的患者分别为7,2,6例,即7例Ⅰb期(N0)和2例Ⅱb期(N1)患者上升为Ⅲa期(N2)。32例早期肺癌患者术前临床分期、术后常规病理分期和免疫组化分期中,N2患者分别占0、18．8％和46．9％。结论病期愈晚,纵隔淋巴结微小转移愈多见,Ber-Ep4免疫组化染色较两平面HE染色更易于发现淋巴结中微小转移灶。临床诊断为早期肺癌患者的临床分期和常规病理分期存在分期偏早现象。     

Elevated activities of MMP-2 in the non-tumorous lung tissues of curatively resected stage I NSCLC patients are associated with tumor recurrence and a poor survival

BACKGROUND AND OBJECTIVES: We wanted to assess whether the level of enzyme activity for a particular matrix metalloproteinase (MMP), and not the amount of expressed protein, in lung tissue could be used as a reliable prognostic biomarker for tumor recurrence leading to poorer survival in a certain subgroup of patients who have undergone curative resection for stage I human NSCLC. METHODS: We determined what type of MMP was significant for tumor recurrence by using a mouse model of pulmonary metastasis with inoculating the footpad with H460 human cancer cells. We then looked for any association between tumor recurrence and the level of enzyme activities for the selected MMP in the tumor and also in the pathologically non-tumorous tissues from 34 stage I lung cancer patients. RESULTS: We obtained H460/PM6 cells having a highly metastatic potential after six repeated cycles of pulmonary metastasis by using the mouse footpad inoculated with the metastasized cancer cells in the previous cycle. We started with human lung cancer cells, H460, and we found that among the tested MMPs we tested for, the level of MMP-2 mRNA was elevated. No significant difference was seen in the level of enzyme activity of the MMP-2 cells from the curatively resected tumor tissues of the stage I NSCLC patients who were later found with or without recurrence. However, the level of MMP-2 enzyme activity was found to be significantly different between the non-tumorous lung tissues from patients later found with and without recurrence, and it was associated with the 5-year survival rate. CONCLUSIONS: This observation suggests that the higher level of MMP-2 enzyme activity in the non-tumorous tissues from the patients could be used as a prognostic biomarker to predict post-operative tumor recurrence and survival for patients with stage I NSCLC. The elevated enzyme activity of MMP-2 in the non-tumorous tissue resected from stage I NSCLC could be used as a prognostic indicator for post-operative tumor recurrence and the patients' poor survival. Further, this could be an important aid for physicians' making decision on whether to subject particular patients to post-operative adjunct chemotherapy.     

Methylation of breast cancer susceptibility gene 1 (BRCA1) predicts recurrence in patients with curatively resected stage I non–small cell lung cancer

BACKGROUND:

Even after early detection and curative resection of early stage non–small cell lung cancer (NSCLC), a significant fraction of patients develop recurrent disease. Molecular biomarkers that can predict the risk of recurrence thus need to be identified to improve clinical outcomes.

METHODS:

Using the methylation‐specific polymerase chain reaction assay, promoter methylation of the breast cancer susceptibility gene 1 (BRCA1) was assessed in cancer tissues from 70 patients with curatively resected stage I NSCLC. The clinical relevance of BRCA1 methylation status was evaluated in terms of outcome of the disease.

RESULTS:

Methylation of the BRCA1 promoter was detected in 13 of 70 patients (18.6%). Multiple logistic regression analysis revealed that BRCA1 methylation was an independent risk factor for recurrence (P = .0197) and that patients with BRCA1 methylation demonstrated significantly poorer recurrence‐free survival compared to those without (P = .0139). Cox's proportional hazard regression analysis revealed that BRCA1 methylation was an independent risk factor for recurrence‐free survival (P = .0155).

CONCLUSIONS:

Methylated BRCA1 can be a potential biomarker that predicts the prognosis after curative resection of stage I NSCLC. Considering that BRCA1 plays a role in chemotherapy‐induced apoptosis, it is plausible that identification of methylated BRCA1 could provide information that is clinically relevant to tailored adjuvant therapy. Cancer 2013. © 2013 American Cancer Society.     

Protein profiles correlated with recurrence of early stage non-small cell lung cancer

Objective:To elucidate protein markers that differentiate stage Ⅰ non-small cell lung cancer (NSCLC) that subsequently develop metastatic disease to those that do not develop metastasis by protein expression profiles.Methods:Matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and two dimensional difference gel electrophoresis (2D-DIGE) platforms were used to separate proteins in whole tumor specimens. Quantitating mRNA expression was used for validation. Results:Twelve proteins were identified as expressed differentially between two groups from protein expression platforms. But from gene expression platform no marker could distinguish patients with recurrent vs. nonrecurrent disease. Conclusion:Analysis of multiple protein markers may be more informative to predict prognosis of early stage lung cancer.     

非小细胞肺癌根治术后残端复发的放射治疗

目的评价和分析非小细胞肺癌根治术后残端复发的放射治疗疗效及预后因素。材料与方法从１９７０年２月至１９９３年初，３９例肺癌根治术后残端复发的病人入组分析。中位年龄５９岁，术后至复发时间３～５０月，始发复发症状至确诊时间０～２０月。伴有淋巴结转移者１８例，残端复发有组织学诊断２８例。８例加腔内放疗８～３０Ｇｙ／１～３次，２例加化疗，６例单纯腔内放疗１２～３０Ｇｙ／２～３次。单纯外照射剂量为４５～７０Ｇｙ，加腔内放疗者为２０～６０Ｇｙ。结果症状缓解率达９０％左右，５年生存率２３．０±７．５％。单纯残端复发者５年生存率３８．１±１１．０％，而伴有淋巴结转移者无３年存活（Ｐ＜０．００３）。始发复发症状至确诊时间＜２月与≥２月者，５年生存率分别为３３．７±１２．０％与１２．６±８．２％（Ｐ＞０．１０４５）。在６例行单纯腔内放疗中，２例长期生存。Ｃｏｘ回归分析仅残端复发是否伴有淋巴结转移为影响预后的重要因素。结论放射治疗是治疗非小细胞肺癌根治术后残端复发的重要手段，尤其单纯残端复发者可取得满意结果     

血清TPS检测对于肺癌的临床应用价值

目的 :探讨血清组织多肽特异性抗原 (TPS)在肺癌患者血清中的表达水平及其对肺癌的临床应用价值。方法 :采用酶联免疫吸附法 ,测定 72例肺癌患者和 114例健康体检者的血清TPS、NSE和CEA水平。结果 :肺癌患者组的TPS、NSE和CEA的表达水平及检测阳性率均显著高于正常对照组 (P <0 0 0 1)。TPS检测阳性率显著高于NSE和CEA(P <0 0 1) ,TPS、NSE和CEA阳性率和浓度均随着临床分期的进展而升高。TPS在肺癌淋巴结转移最为敏感 ,而骨转移表达水平最高。肺癌患者经有效治疗后血清TPS、NSE和CEA水平均明显下降 ,尤其以TPS下降幅度较为显著。结论 :TPS是检出肺癌非常敏感的标志物 ,尤其是淋巴结转移患者 ,对乳腺癌早期诊断、病情判断和疗效评价等均有重要价值 ,而动态观察其水平的临床价值更为可靠。     

Five-year recurrence probabilities in 330 patients curatively resected for stage Ia bronchogenic carcinoma

Three hundred and thirty consecutive cases of resected Stage Ia (TNM UICC classification) lung carcinomas were retrospectively reviewed with the aim of evaluating actuarial probabilities of recurrence within the 5th year from operation, according to the extent of resection, the cell type, and the T number. The probabilities of recurrence according to the pattern of failure were also assessed. Five-year overall probability of recurrence was 46.3%. Pneumonectomies showed a lower rate of relapse (37.4%) than lobectomies (49.2%), even though non significant. However, patients submitted to a lobectomy had a higher rate of 5-year survivors. Cell type had no significant impact on the probability of recurrence. 35.5% of patients with T1 carcinomas had evidence of relapse compared with 51.1% of patients with T2 tumors. This datum is explained by the presence in T1 group of a high share of squamous cell cases. Patients with T1 squamous cell carcinomas had, in fact, the best prognosis (26.5% recurred) among the subgroups obtained by stratification of T number and cell type together; loco-regional failure as exclusive modality of relapse had a 5-year rate of 19.7% and metastatic failure of 30.0%. Adenocarcinomas had a significantly higher impact on the occurrence of brain metastases.     

Varying recurrence rates and risk factors associated with different definitions of local recurrence in patients with surgically resected,stage I nonsmall cell lung cancer

BACKGROUND:

The objective of this study was to examine the effects of different definitions of local recurrence on the reported patterns of failure and associated risk factors in patients who undergo potentially curative resection for stage I nonsmall cell lung cancer (NSCLC).

METHODS:

The study included 306 consecutive patients who were treated from 2000 to 2005 without radiotherapy. Local recurrence was defined either as “radiation” (r‐LR) (according to previously defined postoperative radiotherapy fields), including the bronchial stump, staple line, ipsilateral hilum, and ipsilateral mediastinum; or as “comprehensive” (c‐LR), including the same sites plus the ipsilateral lung and contralateral mediastinal and hilar lymph nodes. All recurrences that were not classified as “local” were considered to be distal.

RESULTS:

The median follow‐up was 33 months. The proportions of c‐LR and r‐LR at 2 years, 3 years, and 5 years were 14%, 21%, and 29%, respectively, and 7%, 12%, and 16%, respectively. Significant risk factors for c‐LR on multivariate analysis were diabetes, lymphatic vascular invasion, and tumor size; and significant factors for r‐LR were resection of less than a lobe and lymphatic vascular invasion. The proportions of distant (nonlocal) recurrence using these definitions at 2 years, 3 years, and 5 years were 10%, 12%, and 18%, respectively, and 14%, 19%, and 29%, respectively. Significant risk factors for distant failure were histology when using the c‐LR definition and tumor size when using the r‐LR definition.

CONCLUSIONS:

Local recurrence increased nearly 2‐fold when a broad definition was used instead of a narrow definition. The definition also affected which factors were associated significantly with both local and distant failure on multivariate analysis. Comparable definitions must be used when analyzing different series. Cancer 2010. © 2010 American Cancer Society.     

肺癌相关肿瘤标志物在诊断上的研究进展

 肺癌相关肿瘤标志物是肺癌组织和细胞由于癌其因及其产物的异常表达所产生的抗原和生物活性物质，包括蛋白质、酶、激素、癌基因产物等。近年来肿瘤标志物成为肿瘤基础和临床应用的一个十分活跃的领域。其对肺癌的辅助诊断、判别类型、估计预后、评价疗效、定位诊断、靶向治疗等均具有重要指导意义。对以癌胚抗原、神经元特性烯醇化酶、细胞角蛋白 19片段、血管内皮生因子、增生细胞核抗原、表皮生长因子受等肺癌相关 肿瘤生物标志物 的研究进展进行阐述。     

凋亡相关基因在Ⅰ、Ⅱ期非小细胞肺癌组织中的表达及临床意义

背景与目的:手术后Ⅰ、Ⅱ期非小细胞肺癌的预后与众多因素有关,凋亡基因在肿瘤的发生发展过程中发挥重要的作用。通过检测凋亡基因Survivin、Bcl-2、Bax和Fas在早期非小细胞肺癌中的表达,探讨其在早期非小细胞肺癌中的临床意义和预后价值。方法:利用免疫组织化学技术检测115例Ⅰ、Ⅱ期非小细胞肺癌及20例肺非肿瘤组织中Survivin、Bcl-2、Bax和Fas的表达,并进行5年生存率的多因素分析。结果:115例Ⅰ、Ⅱ期非小细胞肺癌组织中Survivin、Bcl-2、Bax、Fas的表达率分别为62.61%(72/115)、49.57%(57/115)、31.30%(36/115)和46.96%(54/115),与其在肺非肿瘤组织中的表达分别为10.00%(2/20)、15.00%(3/20)、65.00%(13/20)、80.00%(16/20),差异有显著性(P<0.05);患者5年生存率的多因素分析:TNM分期与Survivin蛋白的阳性表达是Ⅰ、Ⅱ期非小细胞肺癌患者独立预后因素(P<0.01),Survivin阳性组的术后生存时间[(33±7)个月]与阴性组术后生存时间[(52±9)个月]差异有显著性(P<0.05)。结论:在Ⅰ、Ⅱ期非小细胞肺癌中,凋亡相关基因可能对肿瘤的发展与预后产生一定的影响;TNM分期与Survivin基因的阳性表达是Ⅰ、Ⅱ期非小细胞肺癌术后患者的独立预后因素。     

New positron emission tomography derived parameters as predictive factors for recurrence in resected stage I non-small cell lung cancer

Background

The recurrence rate for stage I non-small cell lung cancer is high, with 20–40% of patients that relapse after surgery. The aim of this study was to evaluate new F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) derived parameters, such as standardized uptake value index (SUV_index), metabolic tumor volume (MTV) and total lesion glycolysis (TLG), as predictive factors for recurrence in resected stage I non-small cell lung cancer.

Methods

We retrospectively reviewed 99 resected stage I non-small cell lung cancer patients that were grouped by SUV_index, TLG and MTV above or below their median value. Disease free survival was evaluated as primary end point.

Results

The 5-year overall survival and the 5-year disease free survival rates were 62% and 73%, respectively. The median SUV_index, MTL and TLG were 2.73, 2.95 and 9.61, respectively. Patients with low SUV_index, MTV and TLG were more likely to have smaller tumors (p ≤ 0.001). Univariate analysis demonstrated that SUV_index (p = 0.027), MTV (p = 0.014) and TLG (p = 0.006) were significantly related to recurrence showing a better predictive performance than SUV_max (p = 0.031). The 5-year disease free survival rates in patients with low and high SUV_index, MTV and TLG were 84% and 59%, 86% and 62% and 88% and 60%, respectively. The multivariate analysis showed that only TLG was an independent prognostic factor (p = 0.014) with a hazard ratio of 4.782.

Conclusion

Of the three PET-derived parameters evaluated, TLG seems to be the most accurate in stratifying surgically treated stage I non-small cell lung cancer patients according to their risk of recurrence.     

Ⅰ期非小细胞肺癌术后的预后分析

目的探讨Ⅰ期肺癌术后复发转移的相关因素。 方法收集2010年1月至2015年12月在宁波市第二医院接受手术治疗并定期复查的251例Ⅰ期肺癌患者病历资料，对术后复发转移因素进行分析。 结果251例患者中局部复发与远处转移47例，复发转移率187％；中位随访时间431（95～972）个月。单因素分析显示不同性别、年龄、病理类型、分化程度、是否化疗、肿瘤最大径、胸膜侵犯及脉管癌栓的术后复发转移率差异无统计学意义（P＞005），不同的清扫淋巴结个数（≤15个和＞15个）以及不同的术前血清CEA浓度（＞5 ng／ml和≤5 ng／ml）术后复发转移率差异有统计学意义（P＜005）。多因素分析显示，清扫淋巴结≤15个及术前血清CEA 浓度＞5 ng／ml为肺癌术后复发转移高危因素。 结论术前血清CEA浓度＞5 ng／ml及清扫淋巴结≤15个患者，术后应积极随访。     

Cost-effectiveness of adjuvant chemotherapy with uracil-tegafur for curatively resected stage III rectal cancer

Recently, the National Surgical Adjuvant Study of Colorectal Cancer in Japan, a randomised controlled trial of oral uracil-tegafur (UFT) adjuvant therapy for stage III rectal cancer, showed remarkable survival gains, compared with surgery alone. To evaluate value for money of adjuvant UFT therapy, cost-effective analysis was carried out. Cost-effectiveness analysis of adjuvant UFT therapy was carried out from a payer's perspective, compared with surgery alone. Overall survival and relapse-free survival were estimated by Kaplan-Meier method, up to 5.6 years from randomisation. Costs were estimated from trial data during observation. Quality-adjusted life-years (QALYs) were calculated using utility score from literature. Beyond observation period, they were simulated by the Boag model combined with the competing risk model. For 5.6-year observation, 10-year follow-up and over lifetime, adjuvant UFT therapy gained 0.50, 0.96 and 2.28 QALYs, and reduced costs by $2457, $1771 and $1843 per person compared with surgery alone, respectively (3% discount rate for both effect and costs). Cost-effectiveness acceptability and net monetary benefit analyses showed the robustness of these results. Economic evaluation of adjuvant UFT therapy showed that this therapy is cost saving and can be considered as a cost-effective treatment universally accepted for wide use in Japan.     

Increased IL-10 mRNA expression in tumor-associated macrophage correlated with late stage of lung cancer

Background

Monocyte recruited into the tumor and maturation to tumor-associated macrophage (TAM). Interleukin-10(IL-10) is a potent immunosuppressive cytokine, which can be secreted from both primary tumor and stromal cells. However, there are controversies regarding its role in the progression of cancer. So it is important to isolate TAM from tumor cells to study the role of IL-10 in the progress of cancer. The aim of our study was to determine whether IL-10 expressed by TAM correlated with clinicopathological factors in NSCLC.

Methods

TAM in NSCLC was isolated by short-term culture in serum free medium with the modification to literature reports. The mRNA expression levels of IL-10, cathepsin B, cathepsin S, which were closely related with TAM according to the literatures, were evaluated by Quantitative real-time RT-PCR in 63 NSCLC. The relationships between their expression levels and clinicopathological features were investigated.

Results

We successfully achieved up to 95% purity of TAM, derived from 63 primary lung cancer tissues. TAM expressed high levels of IL-10, cathepsin B in NSCLC. High levels of IL-10 in TAM significantly correlated with stage, tumor size, lymph node metastasis, lymphovascular invasion or histologic poor differentiation.

Conclusions

Our results revealed that TAM with high levels of IL-10 expression may play an important role in the progression of non-small cell lung cancer. The data also suggested that TAMs may involve in tumor immunosuppression through overexpressed IL-10. Additionally, the phenotype of isolated TAM can be potentially used to predict clinicopathological features as well.     

肿瘤相关物质群对肺癌诊断及转归判断的价值

目的探讨肿瘤相关物质群(TSGF)水平对肺癌诊断及转归评估的意义.方法用比色法检测169例肺癌患者(治疗前58例,治疗有效组51例,治疗无效组17例,复发转移组43例)和134例健康人血清TSGF水平.结果治疗前、治疗无效及复发转移组患者血清TSGF水平分别为(76.4±18.0)、(75.2±7.0)和(74.6±12.0)U/ml,均明显高于治疗显效组的(57.3±9.3)U/ml及健康对照的(54.5±5.2)U/ml(P＜0.01);与局部复发组的(67.6±9.1)U/ml;相比,远处转移组患者血清TSGF(78.8±11.4)U/ml水平显著升高(P＜0.01).以64U/ml为临界值时,TSGF对肺癌判断的灵敏度、特异度、阳性预测值和阴性预测值,分别为77.6%、97.0%、91.8%及90.9%.结论检测血清TSGF水平是肺癌诊断、疗效及预后判断的有效指标.