关键词: POK红系髓性致癌因子, FUNDC1, p27, 联合预测, 非小细胞肺癌, 无瘤生存

Abstract: Objective  To analyze the efficacy of the expression of POK erythroid myeloid carcinogenic factor (Pokemon),mitochondrial autophagy receptor protein FUNDC1,and p27 in predicting the 5-year tumor free survival of non-small cell lung cancer (NSCLC) patients after surgery.Methods A prospective study was conducted on 189 patients with NSCLC who underwent surgical treatment in our hospital from January 2018 to September 2019.According to whether there was tumor free survival after 5 years,patients were divided into tumor-free group and non-tumor-free group.The propensity score matching (PSM) method using the nearest neighbor matching method was applied to reduce selection bias between groups.The general information,surgical specimens Pokemon,FUNDC1,and p27 expression were compared between the two groups before and after PSM.Multivariate Logistic regression analysis was used to analyze the factors associated with 5-year tumor free survival after surgery in NSCLC.The value of the receiver operating characteristic (ROC) curve analysis of the expression of Pokemon,FUNDC1,and p27 in surgical specimens for predicting 5-year tumor free survival in NSCLC patients was investigated.The Kappa value was used to test the consistency between the combined prediction results and the actual clinical results.Results There were significant differences in clinical stage,lymph node metastasis,and vascular tumor thrombus between the first two groups of PSM (P＜0.05),while there were no significant differences in age,gender,BMI,family history of cancer,past medical history,tumor diameter,tumor location,and pathological type (P>0.05),there were no significant differences in baseline data between the two groups after PSM (P>0.05),making them comparable.The expression of Pokemon and FUNDC1 in non-tumor group was higher than that in tumor group,while the expression of p27 was lower than that in tumor group (P＜0.001).Multivariate Logistic regression analysis showed that after correcting for clinical data such as age and gender,Pokemon and FUNDC1 were still independent risk factors for 5-year tumor free survival after NSCLC surgery,while p27 was an independent protective factor for 5-year tumor free survival after NSCLC surgery (P＜0.05).The ROC curve shows that the AUC of Pokemon,FUNDC1,p27,and the combined prediction of 5-year tumor free survival after NSCLC surgery are 0.744,0.783,0.755,and 0.907,respectively (P＜0.001).Comparing the AUC of different schemes,the combined AUC is higher than that of Pokemon,FUNDC1,and p27 (Z=3.297,2.673,3.100,P=0.001,0.008,0.002).The external dataset test showed that the consistency between the joint prediction and the actual clinical results was 90.00%,with a Kappa value of 0.769 (P＜0.001).Conclusion The expression of Pokemon,FUNDC1,and p27 in surgical specimens is associated with 5year tumor free survival after NSCLC surgery,showing a certain predictive ability.Combined detection can further improve the prognosis after NSCLC resection.

Key words: Pokemon, FUNDC1, p27, combined predictive, non-small cell lung cancer, tumor free survival