Abstract:

Objective To investigate the correlation between serum pyruvate dehydrogenase kinase 1 （PDK1），secreted frizzled-related protein 4 （SFRP4） and the clinical pathological characteristics of patients with non-small cell lung cancer （NSCLC），as well as their value in prognosis assessment. Methods A total of 104 NSCLC patients （NSCLC group） and 100 patients with benign lung diseases （benign disease group） were enrolled from Baoding Second Central Hospital from May 2020 to May 2022. The clinical data were collected，and the levels of serum PDK1 and SFRP4 were determined. The NSCLC patients were followed up for 3 years，and they were classified into death group（46 cases）and survival group（58 cases）according to their prognosis outcomes. Cox regression analysis was used to evaluate the influencing factors of prognosis in NSCLC patients. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of PDK1 and SFRP4 in predicting patient mortality. The survival situation of NSCLC patients was analyzed using Kaplan-Meier survival curve. Results The serum PDK1 level in NSCLC group was higher than that in benign disease group（P<0.001），and the serum SFRP4 level was lower than that in benign disease group（P<0.001）. There was statistical significance in serum PDK1 and SFRP4 levels among NSCLC patients with different TNM stages，differentiation degrees and lymphatic metastasis（P<0.05）. There was no statistical significance in serum PDK1 and SFRP4 levels among NSCLC patients of different ages，genders and histological types（P>0.05）. Compared with survival group，the serum PDK1 level in death group was increased（P<0.001），and the serum SFRP4 level was decreased（P<0.001）. TNM stage Ⅲ， lymphatic metastasis，elevated serum PDK1 and decreased serum SFRP4 were all risk factors for death in NSCLC patients（P<0.05）. A combined determination model of TNM stage， lymphatic metastasis and serum PDK1 and SFRP4 was constructed using Logistic regression analysis. The areas under curves（AUC）of single and combined determination model of serum PDK1 and SFRP4 for determining the death of NSCLC patients were 0.820 and 0.817，respectively. The 3-year survival rate of high-level PDK1 group （29.27%） was lower than that of low-level group（71.43%）（Log-rank χ²= 19.872，P<0.001）；the 3-year survival rate of low-level SFRP4 group（20.41%）was lower than that of high-level group（76.36%）（Log-rank χ²= 23.141，P<0.001）. Conclusions The serum PDK1 and SFRP4 levels in NSCLC patients are related to tumor low differentiation，high TNM stage and lymphatic metastasis. Serum PDK1 and SFRP4 have certain value in prognosis assessment of NSCLC patients，and they may be prognostic markers.

Key words: Pyruvate dehydrogenase kinase 1, Secreted frizzled-related protein 4, Clinical pathological characteristic, Prognosis, Non-small cell lung cancer