血清降钙素原和D-二聚体与肺癌的相关性及交互作用研究  

Study on the correlation and interaction effect between serum procalcitonin,D-dimer and lung cancer

作　　者：芦永斌 滕永军[1] 魏宁[2] 常锐霞 徐信妮[1] 姚佳[1] 程宁[4] LU Yong-bin;TENG Yong-jun;WEI Ning;CHANG Rui-xia;XU Xin-ni;YAO Jia;CHENG Ning(Technology Depart-merit,the First Hospital of Lanzhou University,Lanzhou 730000,China;Thoracic surgery,the First Hospital of Lanzhou University,Lanzhou 730000,China;Information Management Section,Gansu Provincial Matenity and Child-Care Hospital,Lanzhou 730000,China;Basic Medical College,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一医院科技处,甘肃兰州730000 [2]兰州大学第一医院胸外科,甘肃兰州730000 [3]甘肃省妇幼保健院信息管理科,甘肃兰州730000 [4]兰州大学基础医学院,甘肃兰州730000

出　　处：《中华疾病控制杂志》2018年第9期933-937,共5页Chinese Journal of Disease Control & Prevention

基　　金：甘肃省卫生行业计划项目(GSWST2011-05);甘肃省青年科技基金计划项目(1606RJYA283)

摘　　要：目的探讨降钙素原(procalcitonin,PCT)、血清D-二聚体与肺癌的相关性。方法选取近两年来就诊的肺癌患者166例和同期健康患者或不患有肺部疾病患者166例,采用Spearman秩相关,Logistic剂量反应关系和交互作用研究它们之间的相关性。结果年龄、降钙素原(procalcitonin,PCT)、癌胚抗原(carcinoembryonicantigen,CEA)、D-二聚体与肺癌存在相关性(rs分别为0.289、0.262、0.387和-0.161)。年龄(≥60岁)(OR=2.53,95%CI:1.28~5.00,P=0.008)、PCT异常(OR=2.10,95%CI:1.07~4.14,P=0.032)、CEA异常(OR=11.68,95%CI:4.57~29.82,P=0.001)和D-二聚体异常(OR=1.43,95%CI:1.15~1.68,P=0.001)均是肺癌的影响因素。随着PCT和D-二聚体水平的增加,肺癌患者的危险性增高,呈现一定的剂量反应关系(均有P<0.05)。PCT与D-二聚体间对肺癌具有正相加模型的交互作用,同时作用时会增加肺癌的患病风险(交互作用指数=2.16,95%CI:1.08~5.43;交互作用超额相对危险度=1.29,95%CI:0.68~2.71;交互作用归因比=0.75,95%CI:0.37~1.42)。结论 PCT与D-二聚体偏高是肺癌患者的危险因素,且存在剂量反应关系。PCT与D-二聚体存在正相加模型的交互作用,同时偏高时会增加肺癌的患病风险。Objective To investigate the relationship between procalcitonin （PCT）, serum D-dimer and lung cancer. Methods A total of 166 patients with lung cancer in the last two years and 166 concurrent healthy people or pa- tients without lung diseases were selected. Spearman rank correlation, dose-response relationship of Logistic regression and interaction effect were used to study the correlations between PCT, D-dimer and lung cancer. Results The age, PCT, carcinoembryonic antigen （CEA） and D-dimer were correlated with lung cancer （ rs = 0. 289, 0. 262, 0. 387 and 0. 161 ）. Age （/〉60 years） （ OR = 2. 53, 95% CI： 1.28-5.00, P = 0. 008） , PCT abnormalities （ OR = 2. 10, 95% CI： 1.07- 4. 14, P =0. 032）, CEA abnormalities （ OR = 11.68, 95% CI： 4. 57-29. 82, P = 0. 001 ） and D-dimer abnormalities （ OR = 1.43, 95% CI： 1.15-1.68, P =0. 001 ） were influencing factors of lung cancer. With the increasing of PCT and D- dimer levels, the risk of lung cancer were increasing, which showed a positive dose-response relationship （ all P 〈 0. 05 ）. PCT and D-dimer had a positive additive model interaction with lung cancer, and at the same time increased the risk of lung cancer （ interaction index = 2. 16, 95% CI： 1.08 -5.43 ; interaction the role of excess relative risk = 1.29, 95% CI 0. 68- 2.71 ; interaction attribution ratio =0.75,95% CI： 0. 37-1. 42）. Conclusions High PCT and D-dimer are risk factors of lung cancer, and there is a significant dose-response relationship between them. Meanwhile, there is a positive additive in- teraction effect between PCT and D-dimer in an additive model ,the risk of lung cancer will increase significantly when both of them are at an abnormal high level.

关 键 词：肺癌 降钙素原 D-二聚体 剂量反应关系 交互作用 

分 类 号：R73-311[医药卫生—肿瘤]