ABSTRACT
Objective:To investigate the changes of the expression levels of serum proliferating cell nuclear antigen (PCNA), tumor-specific growth factor (TSGF), soluble E-cadherin (SE-CAD) and the relationship with clinical prognosis of advanced non-small cell lung cancer (NSCLC) patients treated with intensity-modulated radiotherapy combined with chemotherapy.Methods:Eighty-four patients (29 cases of Ⅲ A, 30 Ⅲ B and 25 Ⅳ) with advanced NSCLC treated in our hospital from January 2016 to January 2018 were selected, and all patients were given with intensity-modulated radiotherapy combined with chemotherapy. The expression levels of serum PCNA, TSGF, and SE-CAD were compared among different TNM stages and before and after treatment. The serum PCNA, TSGF, SE-CAD levels were compared among patients with different clinical efficacy. The relationship between serum PCNA, TSGF and SE-CAD levels and clinical efficacy was assessed by Logistic regression analysis. The survival analysis was performed with Kaplan- Meier method. Results:The expression levels of serum PCNA, TSGF and SE-CAD before treatment in stage Ⅳ patients were significantly higher than those in stage Ⅲ B and Ⅲ A patients (584.11±60.25 pg/ml vs. 531.06±51.37 pg/ml and 477.54±46.49 pg/ml, 96.13±7.54 U/ml vs. 8.52±5.91 U/ml and 82.41±5.0 U/ml, 3.02±0.26 ng/ml vs. 2.87±0.22 ng/ml and 2.71±0.15 ng/ml, all P<0.05), and the serum levels of three cytokines in Ⅲ B stage patients were significantly higher than those in their Ⅲ A stage counterparts (all P<0.05). After treatment, the serum levels of PCNA, TSGF and SE-CAD were significantly lower than those before treatment (396.11±50.23 pg/ml vs. 528.37±75.09 pg/ml, 74.81±4.72 U/ml vs. 88.68±6.13 U/ml, 1.92±0.24 ng/ml vs.2.86±0.31 ng/ml, all P<0.05). At 18 months after treatment, the serum levels of PCNA, TSGF and SE-CAD in surviving patients were significantly lower than those of dead patients (332.51±54.32 pg/ml vs. 444.92±60.07 pg/ml, 70.59±6.20 U/ml vs. 78.05±8.44 U/ml, 1.71±0.24 ng/ml vs. 2.08±0.27 ng/ml, all P<0.05). The serum levels of PCNA, TSGF and SE-CAD were significantly associated with clinical prognosis (all P<0.05). Among 84 NSCLC patients, the objective response rate after treatment was 29%(24/84). The survival curves in patients with high expression levels of serum PCNA, TSGF and SE-CAD were significantly lower than those in the low-expression group (all P<0.05). Conclusion:Serum PCNA, TSGF and SE-CAD are highly expressed in patients with advanced NSCLC, which are closely correlated with clinical staging and prognosis and contribute to predicting survival status.
ABSTRACT
Objective To evaluate the clinical factors associated with pathological complete response (pCR) after preoperative neoadjuvant chemoradiotherapy for rectal cancer.Methods A retrospective analysis was performed on the clinical data of 116 patients with rectal cancer,who underwent neoadjuvant chemoradiotherapy followed by radical surgery from January 2009 to December 2012.All patients received pelvic intensity-modulated radiotherapy (50 Gy/25 fractions) with concurrent fluorouracilbased chemotherapy and then underwent radical surgery 4-8 weeks later.The clinical factors associated with pCR or non-pCR were analyzed by Logistic regression.Results Of the 116 patients,20 (17.2％) achieved a pCR after neoadjuvant chemoradiotherapy.The univariate analysis showed that percentage of circumference of the rectal tube invaded by the tumor,preoperative serum carcinoembryonic antigen (CEA) level,T stage,N stage,distance from the anal verge,degree of tumor differentiation,and maximum tumor diameter were associated with pCR or non-pCR after neoadjuvant chemoradiotherapy for rectal cancer.The multivariate analysis revealed that percentage of circumference of the rectal tube invaded by the tumor,preoperative serum CEA level,and T stage were predictive factors for pCR or non-pCR after neoadjuvant chemoradiotherapy for rectal cancer.Conclusions Non-circumferential tumor (percentage of circumference of the rectal tube invaded by the tumor ＜ 75 ％),low CEA level,and early T stage before treatment may be associated with pCR after neoadjuvant chemoradiotherapy for rectal cancer.