[1]于海洋,潘跃银.D-二聚体及FIB对ALK阳性并服用克唑替尼治疗的肺癌患者无进展生存期的预测价值[J].医学信息,2023,36(03):77-83.[doi:10.3969/j.issn.1006-1959.2023.03.016]
　YU Hai-yang,PAN Yue-yin.The Predictive Value of D-dimer and FIB for Progression-free Survival in ALK-positive Lung Cancer Patients Treated with Crizotinib[J].Journal of Medical Information,2023,36(03):77-83.[doi:10.3969/j.issn.1006-1959.2023.03.016]
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D-二聚体及FIB对ALK阳性并服用克唑替尼治疗的肺癌患者无进展生存期的预测价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年03期
页码:
77-83
栏目:
生物信息学
出版日期:
2023-02-01

文章信息/Info

Title:
The Predictive Value of D-dimer and FIB for Progression-free Survival in ALK-positive Lung Cancer Patients Treated with Crizotinib
文章编号:
1006-1959（2023）03-0077-07
作者:
于海洋; 潘跃银
（安徽医科大学附属省立医院肿瘤内科，安徽 合肥 230001）
Author(s):
YU Hai-yang; PAN Yue-yin
(Department of Oncology,Affiliated Provincial Hospital of Anhui Medical University,Hefei 230001,Anhui,China)
关键词:
克唑替尼; D-二聚体; 纤维蛋白原; 无进展生存期
Keywords:
Crizotinib; D-dimer; Fibrinogen; Progression-free survival
分类号:
R734.2
DOI:
10.3969/j.issn.1006-1959.2023.03.016
文献标志码:
A
摘要:
目的 联合生物信息学技术分析D-二聚体（D-D）及纤维蛋白原（FIB）水平对间变性淋巴瘤激酶（ALK）阳性并服用克唑替尼治疗的肺癌患者无进展生存期（PFS）的预测价值。方法 通过GEO数据库对ALK阳性肺癌患者克唑替尼耐药前原发灶和耐药后肝转移灶之间的转录组数据进行生物信息学分析，随后收集经病理确诊为ALK阳性并服用克唑替尼治疗前的肺癌患者临床参数和凝血参数，采用受试者工作特征曲线（ROC）和Kaplan-Meier生存曲线分析各参数的诊断价值和预后评估，另采用单因素和多因素Cox回归分析ALK阳性并服用克唑替尼治疗的肺癌患者PFS独立预测因子。结果 差异基因分析显示，编码纤维蛋白原的FGA、FGG基因在转移灶组高表达；KEGG通路富集分析显示，差异基因主要集中于补体和凝血级联途径。ROC曲线分析显示，FIB、D-D对PFS有良好的预测作用（AUC=0.798、0.906），且低水平FIB及D-D患者PFS长于高水平FIB、D-D（P＜0.05）。单因素Cox回归分析显示，PT、PT-INR、FIB、D-D与PFS相关；多因素Cox回归分析显示，D-D和FIB水平可作为评估ALK阳性并服用克唑替尼治疗的肺癌患者PFS独立预测因子。结论 治疗前FIB和D-D高水平提示ALK阳性并服用克唑替尼治疗的肺癌患者治疗效果及预后较差，且FGA、FGG高表达可能是导致患者快速进展的潜在机制之一。
Abstract:
Objective To analyze the predictive value of D-dimer(D-D) and fibrinogen (FIB) levels on progression-free survival (PFS) in lung cancer patients with anaplastic lymphoma kinase (ALK) positive and treated with crizotinib by bioinformatics.Methods The transcriptome data between primary tumors and liver metastases after crizotinib resistance in ALK-positive lung cancer patients were analyzed by GEO database. Then, the clinical parameters and coagulation parameters of lung cancer patients who were pathologically diagnosed as ALK-positive and treated with crizotinib were collected. The diagnostic value and prognostic evaluation of each parameter were analyzed by receiver operating characteristic curve (ROC) and Kaplan-Meier survival curve. In addition, univariate and multivariate Cox regression analysis was used to analyze the independent predictors of PFS in ALK-positive lung cancer patients treated with crizotinib.Results Differential gene analysis showed that FGA and FGG genes encoding fibrinogen were highly expressed in the metastasis group. KEGG pathway enrichment analysis showed that the differential genes were mainly concentrated in the complement and coagulation cascade pathways. ROC curve analysis showed that FIB and D-D had a good predictive effect on PFS (AUC=0.798, 0.906), and PFS in patients with low FIB and D-D was longer than that in patients with high FIB and D-D (P<0.05). Univariate Cox regression analysis showed that PT, PT-INR, FIB and D-D were correlated with PFS. Multivariate Cox regression analysis showed that D-D and FIB levels could be used as independent predictors of PFS in patients with ALK-positive lung cancer treated with crizotinib.Conclusion The high levels of FIB and D-D before treatment suggest that ALK-positive lung cancer patients treated with crizotinib have poor treatment effect and prognosis, and the high expression of FGA and FGG may be one of the potential mechanisms leading to rapid progression of patients.

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更新日期/Last Update: 1900-01-01