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目的观测血清载脂蛋白A-1(ApoA-1)和α1-抗胰蛋白酶(α1-AT)水平在预测Ⅲ期非小细胞肺癌(NSCLC)同步放化疗敏感性中的意义。方法 2010年3月—2013年3月收治初次治疗的Ⅲ期NSCLC患者60例,均行同步放化疗方案,分别于放疗前、放疗4周、放疗后检测ApoA-1和α1-AT的水平。结果 NSCLC患者ApoA-1和α1-AT水平女性均明显高于男性(P<0.05);不同TNM分期和不同病理类型NSCLC患者之间血清α1-AT水平也有显著差异(P<0.05),ⅢB期较ⅢA期α1-AT水平有所降低(P<0.05),腺癌及非鳞腺癌患者的血清α1-AT水平低于鳞癌患者(P<0.05)。敏感组和抵抗组的血清ApoA-1、α1-AT水平在放疗前比较差异均有统计学意义(P<0.05);抵抗组和敏感组放疗4周后ApoA-1水平明显降低(P<0.05),放疗结束后敏感组明显升高(P<0.05),而2组α1-AT水平放疗4周和放疗后均低于放疗前(P均<0.05)。ROC曲线提示α1-AT在325.2ng/ml时,对放化疗敏感性的预测敏感性为90.21%、特异性为89.02%,优于ApoA-1(分别为76.31%和87.25%)的预测意义。结论血清ApoA-1和α1-AT水平在预测Ⅲ期非小细胞肺癌患者对于同步放化疗的敏感性方面有着重要的意义。
Objective To investigate the significance of serum apolipoprotein A-1 (ApoA-1) and α1-antitrypsin (α1-AT) in predicting the chemosensitivity of concurrent non-small cell lung cancer (NSCLC) Methods From March 2010 to March 2013, 60 patients with initial stage Ⅲ NSCLC were treated with concurrent chemoradiotherapy. The levels of ApoA-1 and α1-AT were measured before radiotherapy and 4 weeks after radiotherapy. Results The levels of ApoA-1 and α1-AT in NSCLC patients were significantly higher than those in men (P <0.05). The serum levels of α1-AT were also significantly different between NSCLC patients with different TNM stages and different pathological types (P0.05) The level of α1-AT in patients with adenocarcinoma and non-squamous cell carcinoma was lower than that in patients with squamous cell carcinoma (P <0.05). The serum levels of ApoA-1 and α1-AT in the sensitive group and the resistant group were significantly lower than those before the radiotherapy (P <0.05), while the levels of ApoA-1 in the sensitive group and the sensitive group were significantly decreased 4 weeks after radiotherapy ), The sensitive group was significantly increased after radiotherapy (P <0.05), while the α1-AT level in 2 groups was lower than that before radiotherapy (P <0.05) after radiotherapy for 4 weeks and after radiotherapy. The ROC curve suggested that the sensitivity and specificity of α1-AT to chemosensitivity to radiotherapy and chemotherapy were 90.21% and 89.02% at 325.2ng / ml, which were better than those of ApoA-1 (76.31% and 87.25% respectively). Conclusions The serum levels of ApoA-1 and α1-AT are of great importance in predicting the sensitivity of concurrent radiochemotherapy in patients with stage Ⅲ non-small cell lung cancer.