河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (12): 1448-1454.doi: 10.3969/j.issn.1007-3205.2021.12.017

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热休克蛋白70及功能成像参数与早期小细胞肺癌预后的关系

  

  1. 广西壮族自治区柳州市人民医院呼吸与危重症医学科,广西 柳州 545000
  • 出版日期:2021-12-25 发布日期:2021-12-27
  • 作者简介:张东伟(1984-),男,河北南宫人,广西壮族自治区柳州市人民医院副主任医师,医学硕士,从事肺部感染、肺癌的诊治研究。

Relationship of heat shock protein 70 and functional imaging parameters with prognosis of early-stage small cell lung cancer

  1. Department of Respiratory and Critical Care Medicine, People′s Hospital of Liuzhou City, Guangxi Zhuang Autonomous Region, Liuzhou 545000, China
  • Online:2021-12-25 Published:2021-12-27

摘要: 目的 分析探讨热休克蛋白70(heat shock protein 70,Hsp70)及18F-脱氧葡萄糖-正电子发射断层扫描显像相关参数与早期局限性小细胞肺癌(limited-disease small cell lung cancer,LD-SCLC)预后的相关性。
方法 收集57例早期局限性小细胞癌患者及57例健康人员(NC组),分析Hsp70及功能成像参数中代谢体积(metabolic tumor volume,MTV)、最大标准化摄取值(maximal standardized uptake values,SUVmax)、平均标准化摄取值(the average standardized uptake values,SUVmean)及整合标准摄取值(intergered SUV,iSUV)与LD-SCLC预后关系。
结果 早期LD-SCLC患者胃泌素释放肽前体、神经元特异性烯醇化酶、乳酸脱氢酶、Hsp70、MTV、SUVmax、SUVmean及iSUV高于健康人员(P<0.05)。Hsp70、MTV及iSUV诊断早期LD-SCLC具有较高灵敏度、特异性。Hsp70≥3.24 μg/L亚组5年内肺癌特异性生存率及疾病无进展生存率低于Hsp70<3.24 μg/L亚组(P<0.05);MTV<64.63 cm3亚组5年内总生存率及疾病无进展生存率高于MTV≥64.63 cm3亚组(P<0.05);iSUV<316.78亚组5年内 总生存率及肺癌特异性生存率高于iSUV≥316.78(P<0.05)。Cox模型回归分析显示,临床分期、胃泌素释放肽前体、神经元特异性烯醇化酶、Hsp70、MTV及iSUV为早期LD-SCLC预后独立危险因素。
结论 MTV、iSUV及Hsp70与早期LD-SCLC早期手术+放化疗治疗的预后密切相关,建议临床进一步加大样本量研究。


关键词: 小细胞肺癌, 热休克蛋白70, 化放疗

Abstract: Objective  To analyze the correlation of heat shock protein 70(Hsp70) and imaging parameters of 18F-fluorodeoxyglucose-positron emission tomography(18FDG-PET) with the prognosis of early-stage limited-disease small cell lung cancer(LD-SCLC). 
Methods  A total of 57 patients with early-stage LD-SCLC and 57 healthy people(NC group) were enrolled to analyze the relationship of Hsp70 and imaging parameters, including metabolic tumor volume(MTV), maximum standardized uptake values(SUVmax), mean standardized uptake values(SUVmean), and integrated standardized uptake values(iSUV), with the prognosis of LD-SCLC. 
Results  The gastrin releasing peptide precursor, neuron-specific enolase, lactate dehydrogenase, Hsp70, MTV, SUVmax, SUVmean and iSUV in patients with early LD-SCLC were higher than those in healthy people(P<0.05). Hsp70, MTV and iSUV had high sensitivity and specificity in the early diagnosis of LD-SCLC. The lung cancer specific survival(LCSS) rate and disease progression-free survival rate(DFS) in the Hsp70≥3.24 μg/L subgroup were lower than those in the Hsp70 <3.24 μg/L subgroup(P<0.05). The 5-year overall survival(OS) and PFS were higher in MTV <64.63 cm3 subgroup than in the MTV≥64.63 cm3 subgroup(P<0.05). The 5-year overall survival(OS) and LCSS rate were higher in the iSUV <316.78 subgroup than in the iSUV≥316.78 group(P<0.05). Cox model regression analysis showed that clinical stage, gastrin releasing peptide precursor, neuron-specific enolase, Hsp70, MTV and iSUV were independent risk factors for the prognosis of early LD-SCLC. 
Conclusion  MTV, iSUV and Hsp70 are closely related to the prognosis of early LD-SCLC patients undergoing early surgery, radiotherapy and chemotherapy treatment. A larger sample size is recommended in future clinical research.


Key words: small cell lung caancer, heat shock protein 70, chemoradiotherapy