血清CA125、TRAP1、HO-1对晚期非小细胞肺癌患者靶向治疗联合化疗疗效的评估价值

doi:10.3969/j.issn.1673-8640.2025.10.007

摘要/Abstract

摘要：

目的探讨血清糖类抗原（CA）125、肿瘤坏死因子受体相关蛋白1（TRAP1）和血红素氧合酶1（HO-1）在晚期非小细胞肺癌（NSCLC）患者靶向治疗联合化疗疗效评估中的价值。方法选取2021年6月—2023年6月秦皇岛市第二医院晚期NSCLC患者100例，采用厄洛替尼（鳞癌）/吉非替尼（腺癌）靶向治疗联合培美曲塞+顺铂化疗。根据疗效将患者分为有效组（53例）和无效组（47例）。收集所有患者的临床资料，并检测血清CA125、TRAP1、HO-1水平。采用Spearman相关分析评估CA125、TRAP1、HO-1水平与疗效的相关性。采用Logistic回归分析评估晚期NSCLC患者靶向治疗联合化疗疗效的影响因素。采用受试者工作特征（ROC）曲线评价血清CA125、TRAP1、HO-1判断晚期NSCLC患者靶向治疗联合化疗疗效的效能。结果无效组和有效组分化程度差异有统计学意义（P<0.05），年龄、性别、吸烟史、病理类型、TNM分期差异均无统计学意义（P>0.05）。无效组血清CA125、TRAP1、HO-1水平均高于有效组（P<0.05）。晚期NSCLC患者血清CA125、TRAP1、HO-1水平均与靶向治疗联合化疗疗效呈负相关（r_s值分别为-0.522、-0.467、-0.493，P<0.05）。分化程度、CA125、TRAP1、HO-1均是晚期NSCLC靶向治疗联合化疗无效的危险因素[比值比（OR）值分别为3.664、4.307、4.139、3.458，95%可信区间（CI）分别为1.838~7.304、1.883~9.849、1.985~8.632、1.426~8.386，P<0.05]。CA125、TRAP1、HO-1单项检测和联合检测诊断模型判断晚期NSCLC患者靶向治疗联合化疗无效的AUC分别为0.756、0.784、0.770、0.878。结论血清CA125、TRAP1、HO-1在晚期NSCLC患者靶向治疗联合化疗疗效评估中均有一定的预测价值，或可作为疗效预测的指标。

关键词: 糖类抗原125, 肿瘤坏死因子受体相关蛋白1, 血红素氧合酶1, 非小细胞肺癌, 靶向治疗联合化疗

Abstract:

Objective To investigate the roles of serum carbohydrate antigen（CA） 125，tumor necrosis factor receptor-associated protein 1（TRAP1） and heme oxygenase-1（HO-1） in the efficacy evaluation of targeted therapy combined with chemotherapy in patients with advanced non-small cell lung cancer（NSCLC）. Methods A total of 100 patients with advanced NSCLC in the Second Hospital of Qinhuangdao from June 2021 to June 2023 were enrolled. All the patients were given erlotinib（squamous carcinoma）/gefitinib（adenocarcinoma） targeted therapy combined with pemetrexed+cisplatin chemotherapy. The patients were classified into effective group（53 cases） and ineffective group（47 cases） according to therapeutic effect. The clinical data were collected，and the levels of serum CA125，TRAP1 and HO-1 were determined. Spearman correlation analysis was used to evaluate the correlation between the levels of CA125，TRAP1 and HO-1 and therapeutic effect. Logistic regression analysis was used to evaluate the influencing factors of the therapeutic effect of targeted therapy combined with chemotherapy in patients with advanced NSCLC. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of serum CA125，TRAP1 and HO-1 in judging the therapeutic effect of targeted therapy combined with chemotherapy in patients with advanced NSCLC. Results There was statistical significance in the degree of differentiation between ineffective group and effective group（P<0.05），and there was no statistical significance in age，gender，smoking history，pathological type and TNM stage（P>0.05）. The levels of serum CA125，TRAP1 and HO-1 in ineffective group were higher than those in effective group（P<0.05）. The levels of serum CA125，TRAP1 and HO-1 in patients with advanced NSCLC were negatively correlated with the therapeutic effect of targeted therapy combined with chemotherapy（r_s values were -0.522，-0.467 and -0.493，respectively，P<0.05）. The degree of differentiation，CA125，TRAP1 and HO-1 were all risk factors for the ineffectiveness of targeted therapy combined with chemotherapy in advanced NSCLC [odds ratios（OR） were 3.664，4.307，4.139 and 3.458，95% confidence intervals（CI） were 1.838-7.304，1.883-9.849，1.985-8.632 and 1.426-8.386，respectively，P<0.05]. The areas under curves（AUC） of single and combined determinations of CA125，TRAP1 and HO-1 for judging the ineffectiveness of targeted therapy combined with chemotherapy in patients with advanced NSCLC were 0.756，0.784，0.770 and 0.878，respectively. Conclusions Serum CA125，TRAP1 and HO-1 have certain predictive value in the efficacy evaluation of targeted therapy combined with chemotherapy in patients with advanced NSCLC，which may be used as the indicators for therapeutic effect prediction.

Key words: Carbohydrate antigen 125, Tumor necrosis factor receptor-associated protein 1, Heme oxygenase-1, Non-small cell lung cancer, Targeted therapy combined with chemotherapy

中图分类号:

R446.1

卢秀明, 柴宝英, 曹颖祺, 刘鑫, 杨琳. 血清CA125、TRAP1、HO-1对晚期非小细胞肺癌患者靶向治疗联合化疗疗效的评估价值[J]. 检验医学, 2025, 40(10): 972-977.

LU Xiuming, CHAI Baoying, CAO Yingqi, LIU Xin, YANG Lin. Roles of serum CA125，TRAP1 and HO-1 in efficacy evaluation of targeted therapy combined with chemotherapy for patients with advanced non-small cell lung cancer[J]. Laboratory Medicine, 2025, 40(10): 972-977.

图/表 5

参考文献 23

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组别	例数	年龄/岁	性别			病理类型
组别	例数	年龄/岁	男/[例（%）]	女/[例（%）]		鳞癌/[例（%）]	腺癌/ [例（%）]
无效组	47	53.34±5.94	27（57.45）	20（42.55）		20（42.55）	27（57.45）
有效组	53	53.06±6.11	28（52.83）	25（47.17）		23（43.40）	30（56.60）
统计值		0.232	0.215			0.007
P值		0.817	0.643			0.932
组别	吸烟史/[例（%）]		TNM分期			分化程度
组别	吸烟史/[例（%）]		Ⅲb期/ [例（%）]		Ⅳ期/ [例（%）]	低分化/ [例（%）]	中高分化/ [例（%）]
无效组	24（51.06）		31（65.96）		16（34.04）	28（59.57）	19（40.43）
有效组	21（39.62）		33（62.26）		20（37.74）	21（39.62）	32（60.38）
统计值	1.317		0.147			3.968
P值	0.251		0.701			0.046

组别	例数	年龄/岁	性别			病理类型
组别	例数	年龄/岁	男/[例（%）]	女/[例（%）]		鳞癌/[例（%）]	腺癌/ [例（%）]
无效组	47	53.34±5.94	27（57.45）	20（42.55）		20（42.55）	27（57.45）
有效组	53	53.06±6.11	28（52.83）	25（47.17）		23（43.40）	30（56.60）
统计值		0.232	0.215			0.007
P值		0.817	0.643			0.932
组别	吸烟史/[例（%）]		TNM分期			分化程度
组别	吸烟史/[例（%）]		Ⅲb期/ [例（%）]		Ⅳ期/ [例（%）]	低分化/ [例（%）]	中高分化/ [例（%）]
无效组	24（51.06）		31（65.96）		16（34.04）	28（59.57）	19（40.43）
有效组	21（39.62）		33（62.26）		20（37.74）	21（39.62）	32（60.38）
统计值	1.317		0.147			3.968
P值	0.251		0.701			0.046

组别	例数	CA125/（U·mL^-1）	TRAP1/（ng·L^-1）	HO-1/（μg·L^-1）
无效组	47	82.33±28.41	64.28±6.79	14.62±2.31
有效组	53	51.42±11.57	51.68±5.17	10.08±2.19
t值		7.273	10.507	10.084
P值		<0.001	<0.001	<0.001

组别	例数	CA125/（U·mL^-1）	TRAP1/（ng·L^-1）	HO-1/（μg·L^-1）
无效组	47	82.33±28.41	64.28±6.79	14.62±2.31
有效组	53	51.42±11.57	51.68±5.17	10.08±2.19
t值		7.273	10.507	10.084
P值		<0.001	<0.001	<0.001

项目	β值	标准误	Wald值	P值	OR值（95%CI）
分化程度	1.299	0.352	13.609	<0.001	3.664（1.838~7.304）
CA125	1.460	0.422	11.974	0.001	4.307（1.883~9.849）
TRAP1	1.420	0.375	14.348	<0.001	4.139（1.985~8.632）
HO-1	1.241	0.452	7.534	0.006	3.458（1.426~8.386）