[Correlation Analysis of Serum LDH Concentration before and after Operation and Prognosis of Large Cell Neuroendocrine Lung Cancer Patients]

Studies have shown that elevated serum lactate dehydrogenase (LDH) concentration can lead to poor prognosis in patients with small cell lung cancer and lung adenocarcinoma, but its relationship with the prognosis of patients with lung large-cell neuroendocrine carcinoma (L-LCNEC) is not clear. This study aims to explore the influence of L-LCNEC preoperative serum LDH concentration and postoperative LDH concentration change trend on the disease-free survival (DFS) of patients after surgery, so as to judge the clinical prognosis of L-LCNEC provides new ideas.Collected the clinical data. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value, while the Kaplan-Meier and Cox proportional hazard model were used to analyze data.DFS was shortened in patients with high serum LDH concentration before operation and increased LDH concentration after operation (P0.001, P0.001). The preoperative LDH concentration and postoperative LDH concentration change trend were independent prognostic factors for patients (P0.001, P=0.037).Preoperative LDH concentration and its postoperative concentration change trend in patients with L-LCNEC are independent prognostic factors for DFS of patients.【中文题目：手术前后血清LDH浓度与大细胞神经内分泌 肺癌患者手术预后的相关性分析】 【中文摘要：背景与目的 血清乳酸脱氢酶（lactate dehydrogenase, LDH）浓度升高，会导致小细胞肺癌、肺腺癌患者预后不佳，但其与大细胞神经内分泌肺癌（lung large-cell neuroendocrine carcinoma, L-LCNEC）患者预后的关系并不清楚，本研究旨在探讨L-LCNEC患者术前血清LDH浓度、术后LDH浓度变化趋势对患者术后无病生存期（disease-free survival, DFS）的影响，从而为判断L-LCNEC的临床预后提供新的思路。方法 本研究共纳入49例L-LCNEC术后患者，通过医疗记录、电话随访获取患者的临床资料。应用受试者操作特征曲线确定术前LDH的最佳临界值。用Kaplan-Meier绘制生存曲线。应用Cox比例风险模型计算独立预后因素。结果 术前血清LDH最佳临界值分别为195.5 U/L。生存曲线显示，术前血清LDH高浓度、术后LDH浓度升高的患者术后DFS缩短（P0.001, P0.001）。多因素分析显示，术前LDH浓度、术后LDH浓度变化趋势是L-LCNEC患者术后DFS的独立预后因素（P0.001, P=0.037）。结论 L-LCNEC患者术前LDH浓度及其术后浓度变化趋势是患者DFS的独立预后因素，术前高浓度、术后浓度升高会导致患者DFS缩短，预后差，应及早进行干预治疗。】 【中文关键词：大细胞神经内分泌肺癌；乳酸脱氢酶；预后】.