The Significance Of Serum Trefoil Factor 3 （TFF3） In The Diagnosis And The Evaluation Of Chemotherapy Efficacy Of Non-small Cell Lung Cancer

Objective:To investigate the role of trefoil factor 3（TFF3）in the diagnosis and the evaluation of chemotherapy efficacy of non-small cell lung cancer（NSCLC）,and to provide a new tumor marker for the diagnosis and treatment evaluation of NSCLC.Methods:From June 20,2020 to June 6,2021,84 patients diagnosed with NSCLC [38 cases of lung squamous cell carcinoma（LUSC）and 46 cases of lung adenocarcinoma（LUAD）]were allocated into NSCLC group in the First Affiliated Hospital of Anhui Medical University,and 21 health checkup confirmed healthy individuals were selected as control group.The NSCLC patients who only received pemetrexed（LUAD）or paclitaxel（LUSC）+ platinum for chemotherapy for two cycles were followed up as the chemotherapy group.In NSCLC patients,the serum TFF3 levels were detected in the initial diagnosis and the end of two cycles of chemotherapy by using the enzyme linked immunosorbent assay（ELISA）,respectively.In the control group,the serum TFF3 levels were detected in the first day of health checkup.The peripheral blood laboratory indexes in NSCLC patients,including neutrophil count,platelet count,lymphocyte count,neuron specific enolase（NSE）,carcinoembryonic antigen（CEA）and cytokeratin19 fragment（CYFRA21-1）,were collected at the first diagnosis.The LUSC and LUAD data in The Cancer Genome Atlas（TCGA）database was downloaded to analyze the association between TFF3 expression level and chemotherapy efficacy.Results:1.In NSCLC group,the levels of TFF3 in patients with LUAD and LUSC were both significantly higher than those in healthy control group before chemotherapy（P < 0.05）.2.The level of TFF3 in NSCLC patients with platelet count ≥ median level was higher than that in patients with platelet count < median level（P < 0.05）.3.The area under the receiver operating characteristic（ROC）curve（AUC）of serum TFF3 level in the diagnosis of NSCLC,LUAD and LUSC were 0.73 [95%CI（0.62,0.83）],0.69 [95%CI（0.56,0.82）],and 0.77 [95%CI（0.66,0.89）],and the Youden index for NSCLC,LUAD and LUSC were 0.45,0.37,and 0.55,respectively.The cut-off values for NSCLC,LUAD and LUSC were 1109.37pg/ml,1109.37 pg/ml,and 1110.61pg/ml,respectively.4.In NSCLC patients,the serum TFF3 level was significantly decreased after chemotherapy than that before chemotherapy（P < 0.05）.In subgroup analysis,the serum TFF3 level was significantly decreased after chemotherapy than that before chemotherapy in LUAD patients,（P < 0.05）,while no significant alteration in TFF3 level was observed in response to chemotherapy in LUSC patients.5.After analyzing the association between chemotherapy efficacy and tissue TFF3 level in NSCLC patients in TCGA database,we found that LUAD patients who had better chemotherapy efficacy had higher TFF3 expression levels（P < 0.05）,which was not found in LUSC patients（P > 0.05）.Conclusion:1.The expression of TFF3 in LUAD and LUSC is higher than that in healthy people,which can be used for the diagnosis of NSCLC patients.2.There is an association between the expression level of TFF3 and the efficacy of chemotherapy in LUAD.3.The expression of TFF3 was increased in NSCLC patients with high platelet expression.