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白蛋白-碱性磷酸酶比值:驱动基因突变阴性晚期非小细胞肺癌患者的新型预后指标。

Albumin-to-alkaline phosphatase ratio: A novel prognostic index for patients with driver mutation-negative advanced non-small cell lung cancer.

机构信息

Department of Pulmonary and Critical Care Medicine, The Affiliated Nanjing Drum Tower Hospital Clinical Medical College of Nanjing Medical University, Nanjing, PR China.

Department of Clinical Laboratory Medicine, The Affiliated Nanjing Drum Tower Hospital Clinical Medical College of Nanjing Medical University, Nanjing, PR China.

出版信息

Clin Respir J. 2021 May;15(5):540-549. doi: 10.1111/crj.13339. Epub 2021 Feb 19.

DOI:10.1111/crj.13339
PMID:33565707
Abstract

INTRODUCTION

Albumin-to-Alkaline Phosphatase Ratio (AAPR), a novel developed prognostic index for cancers. Chemotherapy was the only method for driver mutation-negative advanced non-small cell lung cancer (DANSCLC).

OBJECTIVES

To evaluate the clinical significance of AAPR in these patients.

METHODS

We retrospectively reviewed 167 DANSCLCs and 58 healthy controls. Associations of clinicopathological characteristics and survival analysis were conducted.

RESULTS

Significantly decreased AAPR level was uncovered in DANSCLC patients compared to healthy controls. The correlation analysis revealed that the low AAPR level in DANSCLCs was correlated with poor differentiation (P = .024). Cox regression analysis showed that N stage, M stage, and different levels of AAPR were the independent risk factors of PFS and OS. The median PFS and OS survival ratio in patients with high and low AAPR level was, respectively, 17 months and 8 months, and 23 months and 13 months. The AUC of AAPR for both PFS and OS were higher than that of albumin and alkaline phosphatase (p < 0.05). The low AAPR was associated with much shorter PFS and OS than the high AAPR (mPFS: 8 vs. 25 months; mOS: 12 vs. 36 months). In the AP cohort, the low AAPR group experienced significantly shorter PFS and OS than the high AAPR (mPFS: 7 vs. 25 months; mOS: 12 vs. 36 months). Meanwhile, there was no significance in lung squamous cell carcinoma (LUSC) patients and GP regimens cohort.

CONCLUSION

AAPR significantly decreased in patients with DANSCLC, and it affects the prognosis of patients with DANSCLC and is a biomarker for DANSCLCs prognosis and treatment choice.

摘要

简介

白蛋白-碱性磷酸酶比值(AAPR)是一种新开发的癌症预后指标。化疗是驱动基因突变阴性的晚期非小细胞肺癌(DANSCLC)的唯一治疗方法。

目的

评估 AAPR 在这些患者中的临床意义。

方法

我们回顾性分析了 167 例 DANSCLC 患者和 58 例健康对照者。进行了临床病理特征和生存分析的相关性分析。

结果

与健康对照组相比,DANSCLC 患者的 AAPR 水平显著降低。相关性分析表明,DANSCLC 中低 AAPR 水平与分化不良相关(P=0.024)。Cox 回归分析显示,N 分期、M 分期和不同水平的 AAPR 是 PFS 和 OS 的独立危险因素。高和低 AAPR 水平患者的中位 PFS 和 OS 生存比分别为 17 个月和 8 个月,23 个月和 13 个月。AAPR 对 PFS 和 OS 的 AUC 均高于白蛋白和碱性磷酸酶(p<0.05)。低 AAPR 与较短的 PFS 和 OS 相关,而高 AAPR 则与较长的 PFS 和 OS 相关(mPFS:8 个月比 25 个月;mOS:12 个月比 36 个月)。在 AP 队列中,低 AAPR 组的 PFS 和 OS 明显短于高 AAPR 组(mPFS:7 个月比 25 个月;mOS:12 个月比 36 个月)。同时,在肺鳞状细胞癌(LUSC)患者和 GP 方案队列中没有显著性差异。

结论

AAPR 在 DANSCLC 患者中显著降低,影响 DANSCLC 患者的预后,是 DANSCLC 预后和治疗选择的标志物。

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