Relationship between DNA ploidy of sputum cells and clinical features and prognosis in patients with lung cancer

Yao Junqiang; Mu Xiaoyan; Zhu Lihua; Xiao Ling; Liu Yinxu; Hou Wanxin; Zhou Lei; Li Hegen

doi:10.3760/j.issn.1673-4777.2025.10.009

Abstract：Objective To investigate the relationship between DNA ploidy in sputum cells and pathological characteristics,clinical stage,progression and prognosis of lung cancer patients.Methods A total of 162 patients with primary lung cancer confirmed by cytology or histopathology in Department of Oncology,Longhua Hospital,Shanghai University of Traditional Chinese Medicine from May 2019 to June 2021 were selected.The patients were classified according to age,gender,radiotherapy and chemotherapy,smoking history,family history,pathological type,stage,recurrence and metastasis.The patients were followed up by medical history,physical examination and imaging examination until December 2024.Thex2 test was used to analyze the correlation between DNA ploidy of sputum cells and clinicopathological types,stages and progression of lung cancer.Cox multivariate analysis was used to analyze the correlation between factors such as DNA ploidy of sputum cells and the prognosis of lung cancer.Kaplan-Meier method was used to analyze the survival related to DNA ploidy results of sputum cells.Results There was no significant difference in the incidence of abnormal DNA ploidy in lung cancer patients with different histological types(x2=1.194,P=0.551).The incidence of abnormal DNA ploidy in advanced lung cancer patients was higher than that in early stage patients[66.7％(44/66)vs 40.6％(39/96)](x2=10.616,P=0.001).The incidence of abnormal DNA ploidy in patients with recurrence and metastasis was 66.2％(51/77),and that in patients without recurrence and metastasis was 37.6％(32/85),the difference was statistically significan(x2=13.214,P＜0.001).Cox multivariate analysis showed that radiotherapy(hazard ratio=0.429,95％confidence interval:0.252-0.731,P=0.002)was a protective factor for the prognosis of patients with lung cancer,while positive sputum cell DNA ploidy results(hazard ratio=3.065,95％confidence interval:1.830-5.135,P＜0.001)and smoking history(hazard ratio=4.467,95％confidence interval:2.606-7.657,P＜0.001)were risk factors for the prognosis of patients with lung cancer.The results of Kaplan-Meier survival analysis showed that the patients with positive DNA ploidy expression in sputum cells had a lower survival rate than those with negative DNA ploidy expression,and the difference between the two survival curves was statistically significant(x2=18.387,P=0.003).Conclusion Sputum DNA ploidy analysis is an objective,reproducible and easy to be accepted by patients.Sputum DNA ploidy analysis has good clinical significance for the screening,progression and prognosis evaluation of patients with lung cancer,and can be used as an effective detection method for the diagnosis and prognosis of patients with lung cancer together with other diagnostic methods.