血清甲状腺转录因子-1蛋白的变化特点及在肺癌诊断中的意义分析  

Variation of serum thyroid transcription factor-1 protein and its value in the diagnosis of lung carcinoma

作　　者：李笑[1] 万里燕[2] 申洪[2] 白晓燕[3] 

机构地区：[1]南方医科大学南方医院急诊科,广东广州510515 [2]南方医科大学南方医院病理科,广东广州510515 [3]南方医科大学南方医院广东省肾脏病研究所,广东广州510515

出　　处：《南方医科大学学报》2011年第9期1592-1596,共5页Journal of Southern Medical University

基　　金：国家自然科学基金(81100496);广东省科技计划项目(2008B010600042)~~

摘　　要：目的检测血清中甲状腺转录因子-1(TTF-1)蛋白的变化特点,探讨其在肺癌诊断中的意义。方法应用免疫酶斑点法结合Leica Q500MC图像分析系统定量检测正常成年人、肺良性病变、肺癌及肺外肿瘤(甲状腺癌和非甲状腺来源癌)血清标本中TTF-1蛋白的表达强度。结果本试验方法的灵敏度、特异度、标准化阳性预告值、标准化阴性预告值、标准化准确度和标准化错诊率(SWDR)分别为90.91%、82.22%、83.64%、90.04%、86.57%和13.43%;健康成年人血清TTF-1蛋白PU值的正常截断值为36.39,此时ROC值为0.95。肺腺癌、肺鳞癌和甲状腺癌患者血清TTF-1蛋白的PU值均大于正常成年人、肺良性病变和非甲状腺来源癌(P=0.000);肺腺癌、肺小细胞癌、肺大细胞癌和甲状腺癌血清TTF-1蛋白的PU值基本相同(P=0.744,P=0.677,P=0.333);肺腺癌、肺鳞癌、肺小细胞癌、肺大细胞癌和甲状腺癌血清TTF-1蛋白的PU值均大于其癌组织匀浆(P=0.000);肺癌组织匀浆和血清TTF-1蛋白的PU值与肺癌患者TNM分期有关(P=0.000),与性别、肿瘤大体类型、分化程度和有无淋巴结转移均无关。结论免疫酶斑点法结合图像定量分析技术敏感、特异、可靠,适于血清中TTF-1蛋白的检测。血清TTF-1蛋白的PU值若高于36.39,则提示可能为肺腺癌、肺鳞癌或甲状腺癌;血清TTF-1对于区分肺癌类型及甲状腺癌无意义,在排除甲状腺癌后,血清TTF-1对于肺癌的检测具有辅助作用;不同类型肺癌和甲状腺癌患者血清TTF-1蛋白的表达均高于其癌组织匀浆;肺癌患者血清及组织匀浆TTF-1蛋白的表达随肺癌患者TNM分期的进展而升高。Objective To investigate the variation of serum thyroid transcription factor-1（TTF-1） in different patients and explore its significance in the diagnosis of lung carcinoma.Methods Dot-enzyme linked immunosorbent assay（dot-ELISA） and Leica Q500 MC image analysis system were used to quantitatively detect TTF-1 protein in the serum samples from normal healthy adults and from patients with benign lung disease,lung cancer,thyroid carcinoma and non-thyroid carcinoma.Results The sensitivity,specificity,standardized positive predicative value,standardized negative predicative value,standardized accuracy and standardized wrong diagnostic rate of the method were 90.91%,82.22%,83.64%,90.04%,86.57% and 13.43%,respectively.The cutoff value of serum TTF-1 in healthy normal adults was 36.39,with a ROC value of 0.95.Serum TTF-1 PU was significantly higher in patients with lung adenocarcinoma,squamous cell lung carcinoma and thyroid carcinoma than in healthy adults and patients with benign lung diseases and non-thyroid carcinoma（P=0.000）.Serum TTF-1 PU was similar in lung adenocarcinoma,squamous cell lung carcinoma,small cell lung carcinoma,large cell lung carcinoma and thyroid carcinoma（P=0.744,0.677,and 0.333,respectively）.Serum TTF-1 PU was greater than the PU in the corresponding homogenate of lung adenocarcinoma,squamous cell lung carcinoma,small cell lung carcinoma,large cell lung carcinoma and thyroid carcinoma（P=0.000）.Serum and homogenate TTF-1 PU was correlated to TNM stage of lung cancer patients（P=0.000） but not to gender,tumor types,differentiation or lymph node metastasis.Conclusions Lung adenocarcinoma,squamous cell lung carcinoma and thyroid carcinoma are suspected when serum TTF-1 PU is higher than 36.39.Serum TTF-1 is not helpful in differentiating the types of lung carcinomas and thyroid carcinoma.After exclusion of thyroid carcinoma,detection of serum TTF-1 can be helpful in the diagnosis of lung cancer.In different lung carcinomas and thyroid carcinomas,the serum TTF-1 is higher than t

关 键 词：血清 甲状腺转录因子-1 免疫酶斑点法 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]