肺癌患者血清HE4的预后意义

目的 研究HE4在肺癌患者血清中的表达水平，探讨其在肺癌患者中的预后价值。方法 用酶联免疫吸附试验（ELISA）检测106例健康人及191例肺癌患者的治疗前血清HE4水平，检测各分期及不同病理类型肺癌患者HE4水平，并分析其与预后的关系。结果 肺癌组中位HE4水平91.63 pmol/L明显高于对照组56.42 pmol/L（U=3 081.00，P<0.05）；HE4的受试者工作特征（ROC）曲线下面积（AUC）为0.85，临界值（cut-off值）为82.70 pmol/L时，特异度为95.31%，灵敏度为62.32%。HE4表达与临床分期及病理类型无相关性；低HE4组（<91.63 pmol/L）患者的中位总生存期 （mOS）为36.87个月，高HE4组（≥91.63 pmol/L）患者的mOS为30.43个月（P<0.05）；HE4血清水平为判断肺癌患者预后的独立指标（HR=2.15，95%CI 1.49~3.12， P<0.05）。结论 血清HE4高表达肺癌患者预后较差，应接受积极的辅助治疗。

The prognostic value of serum HE4 in lung cancer

Objective The study was designed to investigate the serum levels of HE4 in patients with lung cancer, and explore its prognostic value. Methods Blood samples of 106 healthy adults and 191 patients with lung cancer before treatment were measured by means of ELISA for HE4 levels in different stages and pathological types, for analyzing prognostic effect of HE4. Results The serum levels of HE4 in patients with lung cancer (median level 91.63 pmol/L) were significantly higher than control group (median level 56.42 pmol/L) (U=3 081.00,P<0.05). AUC of serum HE4 was 0.85, with a cut-off value of 82.70 pmol/L (specificity=95.31%, sensitivity=62.32%). HE4 expression was not statistically related to clinical stage and pathological types of lung cancer. The median overall survival (mOS) was 36.87 months in the HE4-low group and 30.43 months in the HE4-high group (P<0.05), respectively. HE4 level was an independent prognostic factor for overall survival (HR=2.15,95%CI 1.49-3.12, P<0.05). Conclusions The prognosis of patients with high HE4 expression is poor. Therefore, it might be necessary for patients with high level of HE4 to receive more aggressive adjuvant therapy.