Liu Lei, He Ying, Ge Ge, Li Lei, Zhou Ping, Zhu Yihan, Tang Huairong, Huang Yan, Li Weimin, Zhang Li
Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Key Laboratory of Transplantation Engineering and Immunology, Ministry of Health, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
PLoS One. 2017 Aug 2;12(8):e0182168. doi: 10.1371/journal.pone.0182168. eCollection 2017.
Circulating molecules play important roles in lung cancer diagnosis. In addition, plasma lactate dehydrogenase (LDH) and creatine kinase (CK) have been shown to be closely related to tumor progression in breast cancer, prostate cancer, and colonel cancer. However, the relationships between LDH and CK levels with metastasis occurrence and the survival status of lung cancer patients remain unclear.
A total of 1142 lung cancer patients were enrolled in this study and were separated into negative or positive groups, according to the plasma levels of CK or LDH. Patients in both groups were assessed for clinical characteristics, metastasis occurrence, and survival status. The Cox regression model was then introduced to confirm whether CK and LDH could act as independent factors for predicting a poor prognosis.
The results indicated that CK had a close relationship with bone (p < 0.05) and lymph node (p < 0.05) metastases. In addition, LDH was strongly related with bone (p < 0.05), adrenal gland (p < 0.05), and lymph node (p < 0.05) metastases. CK and LDH were also correlated with the survival status of the lung cancer patients (all p < 0.001). According to specific histological classification analysis, it was found that CK was closely related to the survival status of adenocarcinoma (ADC) and squamous cell carcinoma (SCC) patients, while LDH was only correlated with that of ADC patients. Cox regression analysis confirmed that CK and LDH could act as independent factors for predicting a poor prognosis in ADC but not SCC patients.
For the first time, our study confirmed the role of CK in metastasis occurrence and the survival status of lung cancer patients. In addition, it also demonstrated that CK and LDH could be used as independent factors to predict a poor prognosis in ADC patients. The identification of CK and LDH will play important roles in lung cancer diagnosis and poor outcome prediction in the future.
循环分子在肺癌诊断中发挥着重要作用。此外，血浆乳酸脱氢酶（LDH）和肌酸激酶（CK）已被证明与乳腺癌、前列腺癌和结肠癌的肿瘤进展密切相关。然而，LDH和CK水平与肺癌患者转移发生及生存状况之间的关系仍不清楚。
本研究共纳入1142例肺癌患者，根据CK或LDH的血浆水平分为阴性或阳性组。对两组患者的临床特征、转移发生情况和生存状况进行评估。然后引入Cox回归模型，以确认CK和LDH是否可作为预测预后不良的独立因素。
结果表明，CK与骨转移（p < 0.05）和淋巴结转移（p < 0.05）密切相关。此外，LDH与骨转移（p < 0.05）、肾上腺转移（p < 0.05）和淋巴结转移（p < 0.05）密切相关。CK和LDH也与肺癌患者的生存状况相关（均p < 0.001）。根据特定的组织学分类分析，发现CK与腺癌（ADC）和鳞状细胞癌（SCC）患者的生存状况密切相关，而LDH仅与ADC患者的生存状况相关。Cox回归分析证实，CK和LDH可作为预测ADC患者预后不良的独立因素，但不能预测SCC患者。
我们的研究首次证实了CK在肺癌患者转移发生和生存状况中的作用。此外，还表明CK和LDH可作为预测ADC患者预后不良的独立因素。CK和LDH的鉴定将在未来肺癌诊断和不良结局预测中发挥重要作用。
