目的 观察晚期非小细胞肺癌(NSCLC)患者血清胸苷激酶1(TK1)、分泌型蛋白Dikkopf-1(DKK1)水平,并分析血清TK1、DKK 1与NSCLC治疗预后的关系.方法 该研究采用前瞻性队列研究方法,纳入2020年1月至2021年6月上海市第六人民医院金山分院收治的91例晚期NSCLC化疗患者为研究对象.所有患者入院时均接受血清TK1、DKK1水平检测,均在上海市第六人民医院金山分院完成4个化疗周期,并随访3个月,参照相关标准评价患者疾病缓解率,将完全缓解、部分缓解纳入预后良好组,将病变稳定、进展纳入预后不良组,比较两组血清TK1、DKK1水平,采用Logistic回归分析血清TK1、DKK1水平与晚期NSCLC患者治疗预后的关系.结果 91例晚期NSCLC化疗患者中,预后良好58例(63.74%);预后不良33例(36.26%);预后不良组血清癌胚抗原(CEA)、TK1、DKK1水平均高于预后良好组(P<0.05);采用Logistic回归分析,血清TK1、DKK1高水平是晚期NSCLC患者治疗预后不良的影响因素(OR>1,P<0.05);绘制受试者工作特征曲线,结果显示,血清TK1、DKK1单独及联合预测晚期NSCLC患者预后不良的曲线下面积均>0.700,均有一定的预测价值,其中联合预测价值最高.结论 血清TK1、DKK 1水平异常升高可能提示晚期NSCLC患者预后不良高风险,早期监测患者血清TK1、DKK1水平,对预测、评估患者治疗预后有一定积极意义.
Objective To observe the levels of serum thymidine kinase 1(TK1)and secreted protein Dikkopf-1(DKK1)in patients with advanced non-small cell lung cancer(NSCLC),and analyze the relation-ship between serum TK1,DKK1 and the prognosis of NSCLC.Methods This study adopted a prospective co-hort study method,a total of 91 chemotherapy patients with advanced NSCLC admitted in Jinshan Branch of Shanghai Sixth People's Hospital from January 2020 to June 2021 were enrolled as the research objects.All patients received the detection of serum TK1 and DKK1 on admission,completed 4 chemotherapy cycles in Jinshan Branch of Shanghai Sixth People's Hospital and were followed up for 3 months.The disease remission rate was evaluated according to the relevant standards.The patients with complete remission and partial re-mission were included in the good prognosis group,and those with the stable and progressive lesions were in-cluded in the poor prognosis group.The levels of serum TK1 and DKK1 were compared between the two groups.Logistic regression was used to analyze the relationship between the levels of serum TK1 and DKK1 and the prognosis of patients with advanced NSCLC.Results Among 91 patients with advanced NSCLC who received chemotherapy,threre were 58 cases(63.74%)in the good prognosis group,and 33 cases(36.26%)in the poor prognosis group.The levels of serum carcinoembryonic antigen(CEA),TK1 and DKK1 in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Logistic regression anal-ysis showed that the high levels of serum TK1 and DKK1 were the influencing factors of poor prognosis in pa-tients with advanced NSCLC(OR>1,P<0.05).The receiver operating characteristic curve was drawn,and the results showed that the area under the curve of serum TK1,DKK1 alone and combined for predicting the poor prognosis in patients with advanced NSCLC was>0.700,all of which had certain predictive value,and the predictive value of the combined detection was the highest.Conclusion The abnormal increase of serum TK1 and DKK1 levels may indicate a high risk of poor prognosis in patients with advanced NSCLC.Early monito-ring of serum TK1 and DKK1 levels in patients has certain positive significance for predicting and evaluating the prognosis of patients.