Abstract:

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.

Key words: HDAC4, fibrinogen/albumin ratio, non?small cell lung cancer, diagnosis, prognosis