晚期非小细胞肺癌病理特征及放化疗联合治疗疗效与患者血清超氧化物歧化酶的关系

目的：探讨晚期非小细胞肺癌（NSCLC）病理特征、放化疗联合治疗疗效、总生存期与患者血清超氧化物歧化酶（SOD）活力的关系。方法：采用基因表达谱数据动态分析数据库（GEPIA）分析不同肿瘤组织SOD的表达情况。收集2018年1—12月河北工程大学附属医院肿瘤科初次确诊的174例晚期NSCLC患者作为研究对象，80例健康者作为对照，放化疗联合治疗前采集患者外周血，分离血清，WST-1法检测血清中SOD活性，根据实体瘤疗效评价标准（RECIST 1.1）评估疗效，追踪随访，分析晚期NSCLC临床病理特征、放化疗联合治疗疗效、总生存期与SOD活力的关系。结果：GEPIA分析显示33类肿瘤中，19类肿瘤组织SOD表达异常，其中肺鳞状细胞癌和肺腺癌组织SOD表达较对照组显著降低（P < 0.05）；WST-1检测结果显示晚期NSCLC患者血清SOD活力显著低于对照组（P < 0.05），不同年龄、性别、病理类型患者血清SOD活力无显著性差异（P > 0.05）；不同吸烟史及病理分级患者血清SOD有显著性差异（P < 0.05），吸烟者血清SOD活力显著低于无吸烟者（P < 0.05），低分化患者血清SOD活力显著低于中、高分化者（P < 0.05）；患者血清SOD活力与放化疗联合治疗疗效呈正相关（r=0.554，P < 0.05），治疗有效患者血清SOD活力显著高于无效患者（P < 0.05），且SOD高活力组患者总生存期显著高于低活力组（P < 0.05）。结论：NSCLC患者血清SOD活性显著降低，且受患者吸烟史、病理分级的影响，可能与放化疗联合治疗疗效和总生存期有关。血清SOD或可作为评估NSCLC临床疗效和判断预后的潜在指标，辅助NSCLC放化疗的疗效判定及预后评估。

Analyses of clinicopathological characteristics and curative effect of combined radio-with chemo-therapy for advanced non-small cell lung cancer with superoxide dismutase activity in serum

OBJECTIVE: To investigate relationships between clinicopathological characteristics and curative effect of combined radio-with chemo-therapy for advanced non-small cell lung cancer (NSCLC) with superoxide dismutase (SOD). METHODS: 174 newly diagnosed advanced NSCLC patients in the Department of Oncology,Affiliated Hospital of Hebei University of Engineering were selected in 2018 as the research subjects,and 80 healthy subjects were selected as controls. Peripheral blood and serum samples were collected from patients before they had any therapy. Expression of SOD in different tumors was analyzed via gene expression profiling interactive analysis (GEPIA) and activities of SOD in serum were detected via WST-1. Then,relationships between their expressions,clinicopathological chara cteristics and curative effect of therapy were analyzed. RESULTS: On-line analyses via GEPIA show that the expression of SOD in 19 kinds of tumors was abnormal among 33 kinds of tumors. Expression of SOD in lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD) were significantly lower than that in the control group (P < 0.05). The results of WST-1 show that SOD activity in serum of patients was lower than that in the control group (P < 0.05),and there was no difference in serum SOD activity between different ages,genders and pathological patterns of patients (P > 0.05). However,there was significant difference in serum SOD activities between smoking history and pathological grades (P < 0.05). SOD activities were significantly lower in smoking patients compared with non-smoking patients (P < 0.05);and in patients with poor differentiating tumors compared with patients having better differentiating tumors (P < 0.05). SOD activities were positively related to the curative effect of combined therapies (r=0.554,P < 0.05),and it was higher in patients with effective treatment than patients with failed treatment (P < 0.05). Meanwhile,the overall survival in the high activity SOD group was higher than that in the low activity group (P < 0.05). CONCLUSION: SOD activities in serum of patients with advanced NSCLC were significantly decreased. The activities were affected by patients' smoking history,pathological grades,as well as to curative effects of combined therapies and OS. Therefore,SOD can be a potential indicator for evaluating curative effects and prognosis of NSCLC.