血浆硫氧还蛋白还原酶1在NSCLC中的诊断价值  

Plasma thioredoxin reductase 1 is a potential diagnostic biomarker for non-small cell lung cancer

作　　者：张百华[1] 肖琴[2] 丁衍[1] 吴劼[1] 唐金明[1] 梁剑平[1] 王文祥[1] 

机构地区：[1]湖南省肿瘤医院湘雅医学院附属肿瘤医院胸外二科,湖南长沙410006 [2]湖南省肿瘤医院湘雅医学院附属肿瘤医院放疗科,湖南长沙410006

出　　处：《临床和实验医学杂志》2016年第15期1474-1478,共5页Journal of Clinical and Experimental Medicine

基　　金：湖南省自然科学基金联合项目(编号:2015JJ6060)

摘　　要：目的探讨非小细胞肺癌(NSCLC)患者血浆中硫氧还蛋白还原酶1(TRXR1)的诊断意义。方法在82例肺癌和32例健康对照者的血液中,采用酶联免疫吸附法进行TRXR1的检测,同时在肺癌组织芯片中采用免疫组化方法验证TRXR1的表达。结果在51例肺鳞癌患者血浆中,TRXR1中位浓度为6.05 ng/ml,与31例肺腺癌患者的5.94ng/ml相近(P>0.05),高于32例健康对照者中的0.61 ng/ml(P<0.001)。血浆TRXR1水平与NSCLC的肿瘤大小、淋巴结转移、TNM分期等临床病理因素无相关性。TRXR1的ROC曲线下面积(AUC)为0.887,与Cyfra21-1的0.891相近,优于CEA的0.772。TRXR1浓度0.95 ng/ml作为临界值,其Youden指数0.63,而敏感度为97.5%,特异度为65.6%。TRXR1+Cyfra21-1+CEA联合检测时,其AUC值达0.977。选择肺癌中的74例石蜡组织行免疫组化染色,肿瘤组织中TRXR1的阳性表达(85.1%)高于相应正常肺组织的8.1%(P<0.001),与血浆中TRXR1水平升高表现一致。结论 TRXR1可作为NSCLC潜在诊断标志物,当与已有标志物联合应用时能获得更好的诊断效能,值得进一步验证其诊断价值。Objective The discovery of a novel protein biomarker for non - small cell lung cancer（NSCLC）is quite attractive until now. The aim of our study is to detect the presence of thioredoxin reductase 1（TRXR1）in NSCLC patientsˊplasma and determine the diagnostic effica-cy. Methods The elevated level of TRXR1 in 82 NSLC patients and 32 healthy volunteer plasmas was assayed using a commercially available ELISA（Enzyme - Linked Immunosorbnent Assay）kit and the diagnostic efficacy was compared with that of CEA（Carcinoembryonic Antigen）, and Cyfra21 - 1. The expression of TRXR1 in NSCLC tumor tissue and adjacent normal lung tissue was observed via immunohistochemistry stai-ning. Results The median concentration of plasma TRXR1 in 82 NSCLC patients was 6. 04 ng/ ml,significantly higher than that of 0. 61 ng/ ml in 32 healthy volunteers. The plasma levels of TRXR1 in squamous cell carcinoma and adenocarcinoma had no significant difference. No correla-tion between the plasma level of TRXR1 and tumor size,lymph node metastasis,TNM stage,and other clinicopathological factors was observed in the research. The area under the ROC（receiver operating characteristics curves）curve（AUC）of TRXR1 was 0. 887. When 0. 95 ng/ ml was taken as the cut - off value,the maximal Youden index is 0. 63,with the sensitivity of 97. 5% ,and specificity of 65. 6% . The AUC of TRXR1 was similar to Cyfra21 - 1（0. 891）and larger than CEA（0. 772）. Furthermore,the combination of TRXR1 plus Cyfra21 - 1,and CEA showed larger AUC（0. 977）. The expression of TRXR1 protein in NSCLC tumor tissues and adjacent normal lung tissue was investigated in 74 cases using immunohistochemistry staining. The positive staining in tumor tissues（85. 1% ）was significantly increased when compared with normal tissues （8. 1% ）. Conclusion TRXR1 should be considered as a potential diagnostic biomarker in NSCLC. The combination of TRXR1 and other bio-markers have better diagnostic efficacy.

关 键 词：非小细胞肺癌 硫氧还蛋白还原酶1 肿瘤标志物 酶联免疫吸附法 

分 类 号：R734.2[医药卫生—肿瘤]