血清PLOD、CYFRA21-1水平对肺转移瘤患者三维近距离插植放疗疗效的评估价值

doi:10.3969/j.issn.1006-5725.2025.01.020

Abstract

Abstract:

Objective To assess the prognostic value of serum lysine hydroxylase 3 （PLOD3） and cytokeratin 19 fragment （CYFRA21-1） in predicting the efficacy of three-dimensional brachytherapy in patients with pulmonary metastases. Methods A total of 102 patients with lung metastases who underwent three-dimensional brachytherapy at our hospital were selected as the lung metastasis group from August 2021 to August 2023. During the same period， a control group consisting of 60 healthy individuals who underwent physical examinations was selected. The lung metastasis group was further divided into an effective group （n = 66） and an ineffective group （n = 36） based on therapeutic outcomes. Enzyme-linked immunosorbent assay was employed to measure the levels of serum PLOD3 and CYFRA21-1. Multiple logistic regression analysis was conducted to identify factors influencing the efficacy of three-dimensional brachytherapy in the lung metastasis group. Receiver operating characteristic （ROC） curves were used to assess the predictive value of serum PLOD3 and CYFRA21-1 for treatment efficacy. Results The levels of serum PLOD3 and CYFRA21-1 in the case group were （34.47 ± 6.17） μg/L，（27.85 ± 5.14） μg/L， respectively， which exhibited significantly higher values compared to those observed in the control group （7.26 ± 2.21）μg/L，（9.31 ± 2.46）μg/L （P < 0.05）. A positive correlation was found between serum PLOD3 and CYFRA21-1 in the Lung metastasis group （r = 0.667， P = 0.000）. Logistic regression analysis revealed that multiple metastatic lesions along with elevated serum levels of PLOD3 and CYFRA21-1 were identified as risk factors for the efficacy of three-dimensional brachytherapy in patients with lung metastases （P < 0.05）. Furthermore， when combined with three-dimensional brachytherapy， the area under the curve （AUC） for serum PLOD3 and CYFRA21-1 was calculated as 0.868， demonstrating a superior performance compared to individual measurements of either serum PLOD3 alone （AUC = 0.815） or CYFRA21-1 alone （P < 0.05）. Conclusions The levels of serum PLOD3 and CYFRA21-1 are elevated in patients with lung metastases， exhibiting a significant correlation with the efficacy of three-dimensional brachytherapy. The combined utilization of these two biomarkers demonstrates a robust predictive value for treatment efficacy in patients suffering from lung metastases.

Key words: procollagen?lysine， 2?Oxoglutarate 5?Dioxygenase 3, cytokeratin 19 fragment antigen 21-1, pulmonary metastases, three-dimensional brachytherapy, treatment effectiveness

CLC Number:

R734.2

Tingting HU,Hongling LU,Xiaoming YIN,Qian LIU,Wei GUO,Yunchuan SUN. Evaluate value of serum PLOD3 and CYFRA21⁃1 on the efficacy of three⁃dimensional brachytherapy in patients with lung metastases[J]. The Journal of Practical Medicine, 2025, 41(1): 120-125.

Figures/Tables 4

Tab.1

Tab.2

Tab.3

Fig.1

References 22

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参数	有效组（n = 66）	无效组（n = 36）	χ²/t值	P值
性别/［例（%）］			0.029	0.864
男	36	19
女	30	17
年龄（x ± s）/岁	64.41 ± 7.25	63.95 ± 6.41	0.319	0.751
体质量指数（x ± s）/（kg/m²）	20.43 ± 2.11	19.57 ± 2.20	1.938	0.056
KPS评分/［例（%）］			2.533	0.111
≤ 80分	19（28.79）	16（44.44）
> 80分	47（71.21）	20（55.56）
高血压史/［例（%）］	19（28.79）	10（27.78）	0.012	0.914
吸烟史/［例（%）］	15（22.73）	7（19.44）	0.148	0.700
糖尿病史/［例（%）］	7（10.61）	4（11.11）	0.006	0.937
肿瘤原发部位/［例（%）］			1.808	0.613
乳腺癌	12（18.18）	7（19.44）
结直肠癌	29（43.94）	17（47.22）
头颈部癌	11（16.67）	8（22.22）
肝癌及其他	14（21.21）	4（11.11）
转移灶数量/［例（%）］			7.011	0.008
单发	53（80.30）	20（55.56）
多发	13（19.70）	16（44.44）
转移瘤直径/［例（%）］			2.205	0.138
≤ 3 cm	48（72.73）	21（58.33）
> 3 cm	18（27.27）	15（41.67）
病理分化程度/［例（%）］			0.022	0.989
高分化	6（9.09）	3（8.33）
中分化	35（53.03）	19（52.78）
低分化	25（37.88）	14（38.89）
病理类型/［例（%）］			0.153	0.696
腺癌	34（51.52）	20（55.56）
鳞癌	32（48.48）	16（44.44）
影像学表现/［例（%）］			0.005	0.941
典型继发表现	38（57.58）	21（58.33）
非典型继发表现	28（42.42）	15（41.67）
GTV/［例（%）］			3.255	0.071
≤ 60 Gy	28（57.58）	22（61.11）
> 60 Gy	38（42.42）	14（38.89）
无瘤间期/［例（%）］			2.362	0.124
< 36个月	28（57.58）	21（58.33）
≥ 36个月	38（42.42）	15（41.67）
治疗前PLOD3（x ± s）/（μg/L）	30.36 ± 6.04	42.01 ± 6.45	9.089	< 0.001
治疗前CYFRA21-1（x ± s）/（μg/L）	22.61 ± 5.03	37.46 ± 5.34	13.942	< 0.001

因素	赋值	β	SE	Wald χ²	OR	95%CI
转移病灶数目	1=多发，0=单发	0.583	0.166	12.334	1.791	1.294 ~ 2.480
血清PLOD3	原值录入	0.471	0.118	15.932	1.602	1.271 ~ 2.018
血清CYFRA21-1	原值录入	0.460	0.121	14.453	1.584	1.250 ~ 2.008

指标	截断值	约登指数	敏感度	特异度	曲线下面积	95%CI
PLOD3	40.25 μg/L	0.492	0.691	0.801	0.815	0.775 ~ 0.849
CYFRA21-1	35.18 μg/L	0.554	0.724	0.830	0.784	0.745 ~ 0.828
两项联合	-	0.635	0.853	0.782	0.868	0.841 ~ 0.931

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Evaluate value of serum PLOD3 and CYFRA21⁃1 on the efficacy of three⁃dimensional brachytherapy in patients with lung metastases

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