血清ICTP检测对肺癌骨转移的诊断价值及预后评估  

The value of serum ICTP in the diagnosis and prognosis of bone metastasis of lung cancer

作　　者：陈国军[1] 陆建红[1] 董长林[1] 张一帆 王进[1] 陈琪[1] 金益军[1] 

机构地区：[1]武警浙江总队医院,嘉兴314000

出　　处：《武警医学》2010年第2期120-122,共3页Medical Journal of the Chinese People's Armed Police Force

基　　金：嘉兴市科技计划项目(医学研究与试验发展类)(2009BY7007)

摘　　要：目的探讨检测血清I型胶原吡啶交联终肽(ICTP)在肺癌骨转移中的诊断价值及预后评估。方法选取222例肺癌病例,依据正电子发射断层成像/X线计算机断层成像(PET/CT)、核素骨显像检查(ECT)及B超等检查结果,结合临床分为骨转移组、脏器转移组和未转移组,另选60名健康体检者作为对照组,应用酶免疫技术(ELISA)测定各组血清ICTP水平。结果 (1)三组肺癌病例的血清ICTP水平显著高于健康对照组(t=9.809,t=9.864,t=6.052,P均为0.000<0.001);其中骨转移组显著高于脏器转移组和未转移组(t=5.828,t=6.707,P均为0.000<0.001),差异有统计学意义,并与骨侵犯程度呈正相关;脏器转移组与未转移组比较无统计学意义(t=1.68,P=0.097>0.05)。(2)ICTP对肺癌骨转移诊断的灵敏度、特异性和阳性预示值分别为92.9%、87.6%、88.5%。(3)对ECT诊断无骨转移但ICTP检测增高的11例肺癌患者行PET/CT检查,发现骨转移8例。结论血清ICTP能早于除PET/CT外的影像学检查提示肺癌骨转移的存在,可用于筛查、监测肺癌骨转移的发生及预后判断。Objective To evaluate the serum pyridinoline cross-linked carboxyteminal telopeptide of type Ⅰ collagen(ICTP )in the diagnosis of bone metastasis and prognosis in lung cancer patients.Methods According to positron emission tomography/Xray computed tomography(PET/CT),emission computed tomography(ECT)and B-ultrasound inspection results,222 cases of lung cancer were divided into three groups:bone metastasis group,organ metastasis group and non-metastasis group,while 60 healthy volunteers were in control group.The serum ICTP level in each group was detected by enzyme immunoassay(ELISA).Results (1)The serum ICTP level of the three groups markedly higher than that of healthy control group was(t=9.809,P0.05);(2)The sensitivity,specificity and positive predictive value of serum ICTP in bone metastasis of lung cancer were 92.9%、87.6% and 88.5% respectively;(3)Eleven lung cancer cases with increased serum ICTP showed no bone metastasis by inspection of ECT,and then underwent PET/CT examination.Bone metastasis was identified in five of them.Conclusion Compared to other imaging examinations except for PET/CT,serum ICTP showed diagnostic value of bone metastasis of lung cancer,and can be used for screening and monitoring the occurrence of bone metastasis of lung cancer and its prognosis.

关 键 词：检测血清 ICTP 癌骨转移 诊断价值 预后评估 lung cancer 肺癌患者 脏器转移 统计学意义 正电子发射断层成像 PET/CT 影像学检查 计算机断层成像 胶原吡啶交联 对照组 酶免疫技术 健康体检者 预后判断 显像检查 检查结果 

分 类 号：R82[医药卫生—临床医学]