CAJ | 학술논문

本文为前瞻性临床研究，调查骨桥蛋白水平对非小细胞肺癌根治性放疗患者能否提供预后信息。本研究共纳入不可手术的非小细胞肺癌患者69例（M0期55例，M1期14例），分别于放疗前（t0）、放疗结束后第1天（t1）、放疗结束后第4周（t2）应用酶联免疫吸附（ELISA）法检测血浆骨桥蛋白水平。治疗前骨桥蛋白水平与T分期（P＝0．030）、肺功能（P＝0．002）、体重下降（ P＝0．010）、肿瘤体积（ P＝0．020）及血红蛋白浓度（ P＝0．040）有关。M 1期患者骨桥蛋白水平在所有检测时间点均呈现有意义上升（ P＜0．001）。与根治性放疗后骨桥蛋白水平稳定的患者相比，骨桥蛋白升高者无复发时间（ P＝0．008）、总生存时间（ P＝0．004）及无病生存时间（ P＝0．001）更短。放疗后骨桥蛋白水平升高者死亡风险增加3．1倍（ P＝0．003）。骨桥蛋白水平随时间变化，特别是放疗后的变化可为非小细胞肺癌根治性放疗患者提供预后信息。
본문위전첨성림상연구，조사골교단백수평대비소세포폐암근치성방료환자능부제공예후신식。본연구공납입불가수술적비소세포폐암환자69례（M0기55례，M1기14례），분별우방료전（t0）、방료결속후제1천（t1）、방료결속후제4주（t2）응용매련면역흡부（ELISA）법검측혈장골교단백수평。치료전골교단백수평여T분기（P＝0．030）、폐공능（P＝0．002）、체중하강（ P＝0．010）、종류체적（ P＝0．020）급혈홍단백농도（ P＝0．040）유관。M 1기환자골교단백수평재소유검측시간점균정현유의의상승（ P＜0．001）。여근치성방료후골교단백수평은정적환자상비，골교단백승고자무복발시간（ P＝0．008）、총생존시간（ P＝0．004）급무병생존시간（ P＝0．001）경단。방료후골교단백수평승고자사망풍험증가3．1배（ P＝0．003）。골교단백수평수시간변화，특별시방료후적변화가위비소세포폐암근치성방료환자제공예후신식。
This prospective clinical study investigated whether serial OPN measurements during and after curative‐intent radiotherapy for NSCLC provide prognostic information .Sixty‐nine patients with inoperable NSCLC were prospectively enrolled (55 M0 ,14 M1 ) .OPN plasma levels were tested before (t0 ) ,at the end (t1 ) and four weeks after radiotherapy (t2 ) by ELISA .Pre‐treatment OPN levels were associated with T stage (P=0 .030) ,lung function (P=0 .002) ,weight loss (P=0 .010) ,tumor volume (P= 0 .020) and hemoglobin concentration (P=0 .040) .M1 patients had significantly elevated OPN levels at all time points (P<0 .001) .Patients with increasing OPN levels after radiotherapy had inferior freedom from relapse(P=0 .008) ,overall survival (P=0 .004) and disease‐free survival (P=0 .001) compared to patients with stable or decreasing OPN levels .Patients with increasing post‐treatment OPN levels had a 3 .1‐fold increased risk of death (P= 0 .003) .Our results suggest that OPN levels are changing over time ,particularly post‐treatment ,and may yield additional prognostic information in curative‐intent radiotherapy of NSCLC .