血清淀粉样蛋白A在肺癌诊断中的应用  

Clinical diagnostic value of serum amyioid A in patients with lung cancer

作　　者：王胜[1] 束新华[1] 叶珍[1] 叶柳青[1] 宋倩[1] 

机构地区：[1]浙江省肿瘤医院检验科,杭州310038

出　　处：《中华检验医学杂志》2016年第3期220-224,共5页Chinese Journal of Laboratory Medicine

摘　　要：目的探讨肺癌患者血清淀粉样蛋白A（SAA）的表达及其水平变化的临床应用。方法选择2014年4月至2015年6月在浙江省肿瘤医院初次就诊的住院肺癌患者共243例作为肺癌组，147例为男性、96例为女性，年龄范围29～85岁，年龄平均为63岁，95例腺癌、102例鳞癌、46例小细胞癌，Ⅰ和Ⅱ期患者59例、Ⅲa期患者54例、Ⅲb和Ⅳ期患者130例。选择179例来浙江省肿瘤医院体检中心体检的健康人作为对照组，94例男性、85例女性，年龄范围26～86岁，年龄平均是61岁。采用胶乳增强免疫比浊法用日立7600全自动生化分析仪测定血清SAA的水平。评估SAA在肺癌诊断中的临床价值及其与临床病理特征的相关性。运用两独立样本非参数检验（Mann—WhitneyU秩和检验）比较肺癌组和对照组SAA浓度的差异，采用Spearman相关分析和多因素回归分析研究年龄、吸烟史、远端转移与SAA浓度间的关系。结果肺癌组SAA浓度的中位数（四分位数）为42．36mg／L（9．35，74．22），而正常组SAA浓度的中位数为11．24mg／L（3．25，21．45）；肺癌组SAA水平明显高于健康对照组，差异有统计学意义（Z=-2．403，P=0．006）。肺癌组的不同病理类型（Z=-1．013，P=0．339）、年龄（Z=0．578，P=0．458）、性别（Z=0．726，P=0，246）的肺癌患者SAA水平无差异，有吸烟史（Z=-2．282，P=0．013）及发生远处转移（Z=-2．138，P=0．017）的肺癌患者SAA更高。SAA浓度的临界值（14．48mg／L）时绘制诊断肺癌的ROC曲线，得到曲线下面积AUC=0．811，此时准确度为89．12％，敏感度为88．73％。通过Spearman相关分析发现是否有吸烟史、是否具有远端转移组与SAA浓度成正相关，相关系数分别为r=0．331、P=0．018和r=0．372、P=0．015。结论SAA水平测定在辅助诊断肺癌、评估肺癌分期、判断肺癌是否发生远处转移等可能有一定的临价值。Objective To evaluate the clinical value of SAA by detecting their expression levels in patients with lung cancer and the analysis of the relativity of SAA for early diagnosis. Methods There are 243 cases specimens obtained from lung cancer patients who were newly diagnosed and without any treatment in Zhejiang Cancer H ospital from April 2014 to June 2015. The 243 Rung cancer individuals were 147 male, and 96 female, their ages ranged from 29 to 85 years, with an average age of 63 years. The distribution of pathological type was as follows ： 95 patients were adenocarcinoma, 102 patients were squamous carcinoma, and 46 patients were small cell carcinoma. The distribution of TNM staging systems was as follows： 59 patients in stage land stage 2, 54 patients in stage 3, and 130 patients in stage 4. While 179 cases physical examination as the control. There were 94 individuals male, and 85 individuals female. Their ages ranged from 26 to 86 years, with an average age of 61 years. By using latex enhanced immune turbidimetric method, serum SAA concentrations in patients with lung cancer and healthy controls were checked on the Hitachi-7600 automated chemistry analyzer （Hitachi）. The comparisons of all analyses values between healthy controls and lung cancer were estimated by two independent samples nonparametric tests （ Mann- Whitney U）. The association between SAA and lung cancer prognostic factors such as age, smoking status and metastasis, was evaluated by spearman correlation and multivariate analysis. Results The median and interquartile spacing of SAA concentration was 42. 36 mg/L （9.35, 74. 22） in lung cancer patients . While in healthy control was 11.24 mg/L （3.25, 21.45）. The median level of SAA in lung cancer patients （42. 36 rag/L） were significantly higher than in healthy controls （11.24 mg/L） , and difference reached statistically significant （Z = -2. 403 ,P--0. 006）. Nevertheless, there was no significant difference in SAA concentrations among the different pathological typ

关 键 词：血清淀粉样蛋白A 肺肿瘤 诊断 危险性评估 

分 类 号：R734.2[医药卫生—肿瘤]