目的 探讨组蛋白脱乙酰基酶4（histone deacetylase 4， HDAC4）、纤维蛋白原/白蛋白比值（fibrinogen/albumin ratio， FAR）在非小细胞肺癌（non-small cell lung cancer， NSCLC）患者循环中的水平及预后价值，以及二者联合的诊断价值。 方法 应用酶联免疫吸附法测定117例NSCLC患者（肺癌组），50例肺部良性疾病者（参照组），50例健康体检者（健康对照组）血清HDAC4水平，并检测三组纤维蛋白原、白蛋白、癌胚抗原等水平，比较三组HDAC4、FAR水平的差异性，分析HDAC4、FAR与临床特征之间的关联及两者在NSCLC中的诊断及预后价值。 结果 FAR、HDAC4在NSCLC患者循环中水平明显高于参照组及对照组，差异有统计学意义（P < 0.05）。此外， HDAC4、FAR与TNM分期和肿瘤大小、淋巴结转移、远处转移呈正相关（P < 0.05）。HDAC4联合FAR在非小细胞诊断中AUC为0.782，敏感性59%，特异性96%。生存分析表明较高的HDAC4、FAR预示着更短的无进展生存期（progression- free survival， PFS）（log-rank检验，P < 0.05）。多因素分析结果显示HDAC4、FAR、远处转移、手术治疗是影响NSCLC患者预后（PFS）的独立危险因素（P < 0.05）。 结论 HDAC4、FAR在NSCLC患者循环中升高，HDAC4联合FAR在肺癌诊断中有较好的临床参考价值，且较高HDAC4、FAR的NSCLC患者预后较差，二者有望作为评价NSCLC患者预后的指标。

Objective To analyze the levels and prognostic value of histone deacetylase 4 （HDAC4） and the fibrinogen/albumin ratio （FAR） in the circulation of patients with non?small cell lung cancer（NSCLC） as well as the diagnostic value of these two factors combined. Methods The enzyme?linked immunosorbent assay was applied to determine the serum HDAC4 levels and detect the levels of fibrinogen， albumin， and carcinoembryonic antigen in 117 patients with NSCLC （lung cancer group）， 50 patients with benign lung disease （reference group）， and 50 healthy subjects （healthy control group）. The HDAC4 and FAR levels were compared within the three groups. The associations of HDAC4 and FAR with the clinical features and the diagnostic and prognostic value of the two factors combined in NSCLC were analyzed. Results The levels of FAR and serum HDAC4 were significantly higher in the circulation of the NSCLC group compared with the reference and control groups （P < 0.05）. HDAC4 and FAR were positively correlated with TNM stage， tumor size， lymph node metastasis， and distant metastasis （P < 0.05）. HDAC4 combined with FAR had an AUC of 0.782， sensitivity of 59%， and specificity of 96% in non?small cell diagnosis. Survival analysis showed that higher HDAC4， FAR predicted shorter progression?free survival （PFS） （log?rank test， P < 0.05）. Multifactorial analysis showed that HDAC4， FAR， distant metastasis， and treatment regimen were independent risk factors affecting the prognosis （PFS） of patients with non?small cell lung cancer （P < 0.05）. Conclusions HDAC4 and FAR levels are elevated in the circulation of NSCLC patients， and the combination of HDAC4 and FAR has good clinical reference value for lung cancer diagnosis. Moreover， higher levels of HDAC4 and FAR are associated with poorer prognosis in NSCLC patients， suggesting their potential as prognostic indicators for evaluating the prognosis of NSCLC patients.