余晓燕 陆启光 姚杨伟

●论 著

维生素D和维生素D结合蛋白在非小细胞肺癌患者中的表达及其对预后的影响

余晓燕 陆启光 姚杨伟

目的 探讨维生素D和维生素D结合蛋白（DBP）在非小细胞肺癌（NSCLC）患者中的表达及其对预后的影响。方法 选取74例NSCLC患者，采用ELISA法检测患者血清中25（OH）D和DBP的浓度。分析其与患者临床病理特征（包括性别、年龄、肿块大小、淋巴结转移情况、分化程度、组织学类型以及病理分期）及预后的关系。以NSCLC患者的癌旁正常肺组织作为对照，用Western blot检测患者肺癌组织中DBP的表达情况。结果 与癌旁正常肺组织比较，DBP在NSCLC组织中表达下调，差异有统计学意义（P＜0.01）。血清中维生素D和DBP浓度与患者年龄、淋巴结转移及病理分期相关（P＜0.05或0.01）。依据维生素D浓度将患者分为A组[25（OH）D＜25ng/ml]、B组[25ng/ml≤25（OH）D＜40ng/ml]、C组[25（OH）D≥40ng/ml]，依据DBP浓度将患者分为a组（DBP＜20mg/dl）、b组（20mg/dl≤DBP＜40mg/dl）、c组（DBP≥40mg/dl），随着两者浓度增高，患者生存曲线依次上移。Cox比例风险回归模型分析显示，维生素D和DBP的高表达是患者预后的保护因素（均P＜0.05）。结论 血清中维生素D和DBP浓度高低在NSCLC的发生、发展过程中具有重要意义，两者可作为NSCLC患者预后评估的辅助指标。

维生素D 维生素D结合蛋白 非小细胞肺癌 预后

【 Abstract】 Objective To determine serum vitamin D(VD)and vitamin D-binding protein(DBP)levels in non-small cell lung cancer(NSCLC)and its association with the survival of patients. Methods Seventy four NSCLC patients undergoing surgical treatment were included in the study.The serum VD and DBP levels were measured with ELISA and the expression of VD and DBP in lung cancer tissue were detected with Western blot.The association of VD and DBP expression with the cliniopathological parameters and survival of patients was analyzed. Results Serum VD and DBP levels were correlated with pathological stage,lymph node metastasis and ages of patients(P＜0.05 or 0.01).And serum VD and DBP levels were positively correlated with survival of patients.Multivariate analysis revealed that serum VD and DBP level was an independent prognostic indicator for overall survival of patients(both P＜0.05).Compared with corresponding normal lung tissue,the expression of VD and DBP in lung cancer tissue was down-regulated(P＜0.01). Conclusion VD and DBP expression in serum and cancer tissue are decreased in patients with NSCLC,and VD and DBP levels may be used for predicting survival of NSCLC patients.

肺癌是目前全球范围内病死率最高的恶性肿瘤，每年新增病例达120万例，其中最常见的病理类型为非小细胞肺癌（non－small cell lung cancer，NSCLC）[1]，约占80%。维生素D是一种脂溶性维生素，其在循环系统的主要存在形式为25（OH）D，研究发现其不仅在钙磷代谢方面发挥作用，而且能够抑制肿瘤细胞增殖、侵袭和血管新生，并能促进肿瘤细胞凋亡[2]。……