非小细胞肺癌患者血浆D-二聚体水平与多基因共突变的相关性研究

非小细胞肺癌患者血浆D-二聚体水平与多基因共突变的相关性研究摘要：

目的：探讨非小细胞肺癌患者血浆D-二聚体水平与多基因共突变的相关性。

方法：收集2019年1月至2020年12月肺癌病例，选取符合纳入标准的非小细胞肺癌患者100例，采用Next-GenerationSequencing技术检测51个肺癌相关基因，并采用酶联免疫吸附试验测定患者血浆D-二聚体水平，分析D-二聚体水平与基因突变的相关性。

结果：研究结果显示，患者血浆D-二聚体水平与EGFR、KRAS、TP53、BRAF等基因的突变有相关性，其中EGFR突变患者D-二聚体水平明显升高（P<0.05），而TP53突变患者D-二聚体水平明显降低（P<0.05）。多基因共突变的患者D-二聚体水平显著高于单基因突变和野生型患者（P<0.01）。

结论：非小细胞肺癌患者血浆D-二聚体水平与多基因共突变有相关性。D-二聚体水平的变化可能为临床肺癌治疗提供新的预测和监测指标。

关键词：非小细胞肺癌，D-二聚体，多基因共突变，Next-GenerationSequencing，基因突变

Abstract:

Objective:ToexplorethecorrelationbetweenplasmaD-dimerlevelsandmulti-geneco-mutationsinpatientswithnon-smallcelllungcancer.

Methods:100casesofnon-smallcelllungcancerpatientswhomettheinclusioncriteriawereselectedfromJanuary2019toDecember2020.Next-GenerationSequencingtechnologywasusedtodetect51lungcancer-relatedgenes,andenzyme-linkedimmunosorbentassaywasusedtodeterminetheplasmaD-dimerlevelsofpatients.ThecorrelationbetweenD-dimerlevelsandgenemutationswasanalyzed.

Results:TheresultsshowedthatplasmaD-dimerlevelswerecorrelatedwithgenemutationssuchasEGFR,KRAS,TP53,BRAF,andsoon.TheD-dimerlevelsofpatientswithEGFRmutationweresignificantlyincreased(P<0.05),whiletheD-dimerlevelsofpatientswithTP53mutationweresignificantlydecreased(P<0.05).TheD-dimerlevelsofpatientswithmulti-geneco-mutationsweresignificantlyhigherthanthoseofpatientswithsingle-genemutationsandwildtype(P<0.01).

Conclusion:PlasmaD-dimerlevelsarecorrelatedwithmulti-geneco-mutationsinpatientswithnon-smallcelllungcancer.ChangesinD-dimerlevelsmayprovidenewpredictionandmonitoringindicatorsforclinicallungcancertreatment.

Keywords:Non-smallcelllungcancer,D-dimer,Multi-geneco-mutations,Next-GenerationSequencing,GenemutationNon-smallcelllungcancerisacomplexdiseasethatisoftenassociatedwithgenemutations.Theidentificationofspecificgenemutationsandtheirsubsequenttreatmentcanimprovepatientoutcomes.Next-GenerationSequencing(NGS)hasgreatlyadvancedourabilitytoidentifythesegenemutations.

Inthisstudy,weinvestigatedthecorrelationbetweenplasmaD-dimerlevelsandgenemutationsinpatientswithnon-smallcelllungcancer.Ourresultsshowedthatpatientswithmulti-geneco-mutationshadsignificantlyhigherD-dimerlevelsthanthosewithsingle-genemutationsandthosewithwildtype.ThisimpliesthatchangesinD-dimerlevelsmayserveasausefulindicatorformonitoringtheprogressionoflungcancerinpatientswithmulti-geneco-mutations.

ThefindingsofthisstudysuggestthatNGStechnologycanbeusedtoidentifymultiplegenemutationsinpatientswithnon-smallcelllungcancer.Furthermore,theassociationbetweenD-dimerlevelsandmulti-geneco-mutationsmayprovidenewinsightsintothemanagementoflungcancer.FurtherresearchisneededtoconfirmthesefindingsandtoexplorethepotentialofD-dimerasamarkerforlungcancerprognosisandtreatmentInadditiontothepotentialuseofNGStechnologyandD-dimerlevelsinlungcancermanagement,thisstudyalsohighlightsthecomplexityofgenemutationsinlungcancer.Withtheidentificationofmultiplegenemutationsinasinglepatient,theapproachtotreatmentmaybecomemorechallengingaseachmutationcouldrequireadifferenttargetedtherapy.

Thisunderscorestheneedforpersonalizedmedicineinlungcancertreatment.Byanalyzingapatient'sindividualgeneticmakeup,cliniciansmaybeabletotailortreatmentspecificallytothemutationspresentintheirtumor,potentiallyimprovingoutcomesandreducingsideeffectsfromnon-specifictherapies.

However,withtheincreasingcomplexityofNGStechnologyandthevastamountofgeneticdataitgenerates,standardizationandinterpretationofresultsremainachallenge.ItiscrucialthatfurtherresearchisconductedtoestablishguidelinesforinterpretationofNGSresultsandtoensurethatcliniciansareequippedwiththenecessarytoolsandknowledgetoeffectivelyusethistechnologyinpatientcare.

Inconclusion,thestudyonmulti-geneco-mutationsinnon-smallcelllungcancerusingNGStechnologyandtheassociationbetweenD-dimerlevelshighlightsthepotentialforpersonalizedmedicineinmanaginglungcancer.However,furtherresearchisneededtoconfirmthesefindingsandtoestablishguidelinesfortheuseofNGStechnologyinclinicalpracticeMoreover,itisimportanttoconsidertheethicalandsocialimplicationsofpersonalizedmedicineincancermanagement.Whilepersonalizedmedicinehasthepotentialtoimproveoutcomesforpatients,itmayalsoraiseconcernsaboutaccesstocareandaffordability.Inaddition,patientsmayhaveconcernsabouttheprivacyandsecurityoftheirgeneticinformation.

Toaddresstheseconcerns,healthcareprovidersandpolicymakersmustworktogethertoensurethatpersonalizedmedicineisaccessibleandaffordableforallpatients,whilealsoensuringprivacyandsecurityofpatientdata.Thismayinvolvedevelopingregulationsandstandardsfortheuseofgenomicsinclinicalpracticeandpromotingeducationandawarenessaboutthebenefitsandpotentialrisksofpersonalizedmedicine.

Overall,thestudyonmulti-geneco-mutationsandD-dimerlevelsinnon-smallcelllungcancerhighlightsthepotentialofNGStechnologyandpersonalizedmedicineincancermanagement.However,furtherresearchisneededtoconfirmthesefindingsandtodevelopguidelinesfortheuseofgenomicsinclinicalpractice.Itisalsoimportanttoconsiderthe