Sinn Katharina, Elbeialy Ahmed, Mosleh Berta, Aigner Clemens, Schelch Karin, Laszlo Viktoria, Dome Balazs, Hoda Mir Alireza, Grusch Michael
Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria; Center for Cancer Research, Medical University of Vienna, Vienna, Austria.
Transl Oncol. 2025 Jan;51:102153. doi: 10.1016/j.tranon.2024.102153. Epub 2024 Oct 15.
Lung squamous cell carcinoma (LUSC) is associated with a poor prognosis and a lack of specific treatment options. The dysregulation of activin A (ActA) has been reported in various malignancies. Herein, we investigated the diagnostic and prognostic significance of ActA in LUSC.
ActA concentrations were measured using ELISA in plasma samples of 128 LUSC patients (stage I-IV) and 73 controls, and correlated those values with clinicopathological parameters and survival.
ActA plasma levels were significantly higher in therapy-naive LUSC patients compared to controls (444.1 ± 310.9 pg/mL vs 338.9 ± 145.5 pg/mL, p = 0.010). ActA levels significantly correlated with advanced stage as well as with T and N factors. High circulating ActA levels were significantly increased in metastatic disease patients compared to M0 disease. Further, patients with ActA levels above a computationally established optimal cut-off value of 443.0 pg/mL had a significantly worse median overall (OS, 17.63 vs 64.77 months, HR 0.391, 95 % CI 0.200-0.762, p < 0.001) and median disease-/progression-free survival (DFS/PFS; 11.57 vs 30.20 months, HR 0.502, 95 % CI 0.248-1.019, p = 0.020). Multivariate analysis revealed that high ActA levels were an independent prognostic factor for shorter OS (p = 0.001) and DFS/PFS (p = 0.018). A newly developed score combining CRP and ActA levels was also an independent prognostic factor for OS and DFS/PFS.
Measurement of circulating ActA levels may help identify advanced-stage LUSC patients, and this value could serve as a prognostic parameter in LUSC. Thus, ActA may be a novel blood-based biomarker for identifying LUSC patients with distant metastasis.
肺鳞状细胞癌（LUSC）预后较差且缺乏特异性治疗方案。已有报道称激活素A（ActA）在多种恶性肿瘤中存在失调。在此，我们研究了ActA在LUSC中的诊断和预后意义。
采用酶联免疫吸附测定法（ELISA）检测128例LUSC患者（I - IV期）和73例对照者血浆样本中ActA的浓度，并将这些值与临床病理参数及生存率相关联。
与对照组相比，未经治疗的LUSC患者血浆中ActA水平显著更高（444.1±310.9 pg/mL对338.9±145.5 pg/mL，p = 0.010）。ActA水平与晚期以及T和N因子显著相关。与M0期疾病相比，转移性疾病患者循环中ActA水平显著升高。此外，ActA水平高于通过计算确定的最佳临界值443.0 pg/mL的患者，其总生存期（OS，17.63对64.77个月，HR 0.391，95%CI 0.200 - 0.762，p < 0.001）和疾病/无进展生存期（DFS/PFS；11.57对30.20个月，HR 0.502，95%CI 0.248 - 1.019，p = 0.020）的中位值显著更差。多变量分析显示，ActA水平升高是OS缩短（p = 0.001）和DFS/PFS缩短（p = 0.018）的独立预后因素。一种新开发的结合CRP和ActA水平的评分也是OS和DFS/PFS的独立预后因素。
检测循环中ActA水平可能有助于识别晚期LUSC患者，该值可作为LUSC的预后参数。因此，ActA可能是一种用于识别有远处转移的LUSC患者的新型血液生物标志物。
