吉西他滨联合奈达铂治疗的非小细胞肺癌患者血清CDA水平变化及意义

目的：探讨吉西他滨联合奈达铂治疗的非小细胞肺癌（NSCLC）患者血清胞苷脱氨酶（CDA）水平变化及意义。方法：选取2013年3月-2015年4月我院收治的93例NSCLC患者为研究对象。二辛可宁比色测定法检测治疗前后NSCLC患者血清CDA水平。记录治疗后NSCLC患者3年总生存率及无瘤生存率。分析血清CDA水平与NSCLC患者总生存期及无瘤生存期的关系。结果：NSCLS患者治疗前血清CDA及IGF-1水平明显高于吉西他滨联合奈达铂治疗后NSCLC患者血清CDA水平（7.37±2.04） U·mg^-1 vs（5.33±1.45） U·mg^-1；（346.32±82.76）μg·L^-1 vs（105.84±33.02）μg·L^-1，P<0.05]。相关性分析显示血清CDA与IGF-1呈正相关。吉西他滨联合奈达铂治疗后NSCLC患者1年、2年、3年生存率分别为64.52%（60/93）、41.94%（39/93）、22.58%（21/93）；吉西他滨联合奈达铂治疗后NSCLC患者1年、2年、3年无瘤生存率为56.99%（53/93）、33.33%（31/93）、12.90%（12/93）。死亡组患者血清CDA水平明显高于生存组患者（5.64±1.43） U·mg^-1 vs（4.27±0.84） U·mg^-1，P<0.05]。Cox单因素及多因素分析显示临床分期、ECOG-PS、淋巴结转移、肿瘤直径、IGF-1、CDA与NSCLC患者总生存期关系密切。Cox单因素及多因素分析显示临床分期、IGF-1及CDA与NSCLC无瘤生存期关系密切。结论：吉西他滨联合奈达铂治疗后NSCLC患者血清CDA、IGF-1水平降低，且血清CDA、IGF-1水平及TNM分期与吉西他滨联合奈达铂治疗的NSCLC患者生存预后密切相关。

Changes and significance of serum CDA levels in NSCLC patients treated with gemcitabine and nedaplatin

OBJECTIVE To investigate the changes and significance of serum cytidine deaminase (CDA) levels in patients with non-small cell lung cancer (NSCLC) treated with gemcitabine and nedaplatin.METHODS Ninety-three patients with NSCLC admitted to our hospital from March 2013 to April 2015 were selected as the study subjects. Serum CDA levels in NSCLC patients before and after treatment were measured by bicinchonine colorimetric assay The 3-year overall survival rate and tumor-free survival rate of NSCLC patients were observed and recorded. The relationship between serum CDA levels and overall survival and tumor-free survival of NSCLC patients was analyzed.RESULTS The serum levels of CDA and IGF-1 in NSCLS patients before treatment were significantly higher than those in NSCLC patients after gemcitabine combined with nedaplatin treatment(7.37±2.04) U·mg^-1 vs (5.33±1.45) U·mg^-1; (346.32±82.76) μg·L^-1 vs (105.84±33.02) μg·L^-1,P<0.05]. The correlation analysis showed that serum CDA was positively correlated with IGF-1. The 1-year, 2-year and 3-year survival rates of NSCLC patients treated with gemcitabine and nedaplatin were 64.52% (60/93), 41.94% (39/93) and 22.58% (21/93), respectively; the 1-, 2- and 3-year disease-free survival rates of NSCLC patients treated with gemcitabine plus nedaplatin were 56.99% (53/93), 33.33% (31/93) and 12.90% (12/93), respectively. The serum CDA level of patients in the death group was significantly higher than that of patients in the survival group(5.64±1.43) U·mg^-1 vs (4.27±0.84) U·mg^-1,P<0.05]. Cox univariate and multivariate analysis showed that clinical stage, ECOG-PS, lymph node metastasis, tumor diameter, IGF-1, CDA were closely related to the overall survival of NSCLC patients. Cox univariate and multivariate analysis showed that clinical stage, IGF-1, and CDA were closely related to progression-free survival of NSCLC.CONCLUSION The serum levels of CDA and IGF-1 in NSCLC patients treated with gemcitabine plus nedaplatin are decreased, and the serum levels of CDA, IGF-1 and TNM stage are closely related to the survival prognosis of NSCLC patients treated with gemcitabine plus nedaplatin.