巨噬细胞抑制因子-1与早期非小细胞肺癌诊断及预后相关性

BACKGROUND AND OBJECTIVE: Increased macrophage inhibitory cytokine-1 (MIC-1), member of transforming growth factor-β (TGF-β) superfamily, was found in patients serum with epithelial tumors. Therefore, our aim was to delineate the diagnostic and prognostic value of serum MIC-1 in patients with stage Ⅰ-Ⅱ non-small cell lung cancer (NSCLC). METHODS: A total of 152 consecutive patients with stage Ⅰ-Ⅱ NSCLC were prospectively enrolled and underwent follow up after total resection of tumor. Serum MIC-1 level was detected in lung cancer patients by ELISA, 48 benign pulmonary disease patients and 105 healthy controls, and was correlated with clinical features and prognosis of patients. RESULTS: The level of MIC-1 of NSCLC patients was significantly higher than that of controls (P < 0.001) and benign pulmonary disease patients (P < 0.001). A threshold of 1, 000 pg/mL could be used to diagnose early-stage NSCLC with 70.4% sensitivity and 99.0% specificity. The level of MIC-1 was associated with elder age (P=0.001), female (P=0.03) and T2 (P=0.022). A threshold of 1, 465 pg/mL could identify patients with early poor outcome with 72.2% sensitivity and 66.1% specificity. The overall 3-year survival rate in patients with high level of MIC-1 (≥1, 465 pg/mL) was significantly lower than that of patients with low MIC-1 level (77.6% vs 94.8%). Multivariable Cox regression revealed that a high level of MIC-1 was an independent risk factor for compromised overall survival (HR=3.37, 95%CI: 1.09-10.42, P=0.035). CONCLUSION: High level of serum MIC-1 could be served as a potential biomarker for diagnosis and poorer outcome in patients with early-stage NSCLC.