Objective To analyze the changes of circulating tumor cell (CTCs), proliferating nuclear antigen (PCNA), and annex protein A2 (ANXA2) levels in patients with non-small cell lung cancer (NSCLC), and to explore the relationship between CTCs and different clinicopathologic features and prognosis of NSCLC patients. Methods A total of 115 NSCLC patients admitted to the Respiratory Department of Shijiazhuang People's Hospital from January 2015 to June 2016 were selected as the cancer group, 100 patients with benign lung lesions were selected as the benign group, and 100 healthy patients from the Physical Examination Center during the same period were collected as the control group. The clinical data of the three groups of subjects were retrospectively analyzed. The differences in the expression of CTCs, PCNA, and ANXA2 of the three groups were compared, and the patients were followed up regularly through weekly telephone follow-up to record the survival of NSCLC patients for 50 months. Cox regression was used to analyze the independent risk factors affecting the prognosis of NSCLC patients, and Kaplan-Meier method was used for survival analysis. Results The levels of CTCs, PCNA and ANXA2 in cancer group were significantly higher than those in benign group and control group, and those in benign group were higher than those in control group, with statistical significance (P<0.05). Taking the results of lung cancer pathological sections as the gold standard, the subject work curve of CTCs, PCNA and ANXA2 for the diagnosis of lung cancer showed that the area under the curve of the combined detection of CTCS, PCNA and ANXA2 was 0.958, the sensitivity was 92.0%, and the specificity was 94.6%. According to univariate analysis based on different pathological features, CTCs, PCNA and ANXA2 significantly increased in patients with smoking history, tumor diameter ≥ 5 cm, TNM stage Ⅲ~Ⅳ, low differentiation, lymph node metastasis or distant metastasis, and the difference was statistically significant (P<0.05). Pearson correlation analysis showed that CTCs, PCNA, ANXA2 and NSCLC patients had tumor diameter (r=0.602, r=0.543, r=0.743), TNM stage (r=0.238, r=0.307, r=0.342), lymph node metastasis (r=0.391, r=0.387, r=0.421) and distant metastasis (r=0.296, r=0.274, r=0.198) were positively correlated with the degree of differentiation (r=-0.334, r=-0.372, r=-0.403) (P<0.05). Cox regression analysis showed that TNM stage, differentiation degree, lymph node metastasis, distant metastasis, and positive expression of CTCs, PCNA, and ANXA2 were independent risk factors for poor prognosis in NSCLC patients. Kaplan-meier survival curve showed that high levels of CTCs, PCNA and ANXA2 were closely related to the survival of NSCLC patients. Conclusions CTCs, PCNA and ANXA2 significantly increase in NSCLC patients, which are closely related to different clinicopathological features and are independent risk factors for poor prognosis. Combined detection is helpful for early diagnosis and prognosis. |