呼出气冷凝液CEA、P53蛋白、miRNA21检测对孤立性肺结节早期肺癌的诊断价值及临床相关性研究  

Study on the diagnostic value and clinical correlation of exhaled breath condensate CEA,P53 protein and miRNA21 detection in solitary pulmonary nodules in the early stage of lung cancer

作　　者：罗家友[1] 周凌燕[1] 张丽娟[1] 华锋[1] 马志红[2] 沈绮斌 王斌[1] 崔恩海[1] LUO Jiayou;ZHOU Lingyan;ZHANG Lijuan;HUA Feng;MA Zhihong;SHEN Qibin;WANG Bin;CUI Enhai(Department of Respiratory Medicine,Huzhou Central Hospital in Zhejiang Province,Huzhou　313000,China;Central Laboratory,Huzhou Central Hospital in Zhejiang Province,Huzhou　313000,China;Department of Thoracic Surgery,Huzhou Central Hospital in Zhejiang Province,Huzhou　313000,China)

机构地区：[1]浙江省湖州市中心医院呼吸内科,浙江湖州313000 [2]浙江省湖州市中心医院中心实验室,浙江湖州313000 [3]浙江省湖州市中心医院胸外科,浙江湖州313000

出　　处：《中国现代医生》2018年第7期5-8,共4页China Modern Doctor

基　　金：浙江省湖州市科学技术局科技计划项目(2015GY25)

摘　　要：目的探讨呼出气冷凝液(exhaled breath condensate,EBC)癌胚抗原(carcinoembryonic antigen,CEA)、P53蛋白、miRNA21在肺癌组患者中的诊断价值及临床相关性。方法随机选择2014年12月～2017年6月入住我院呼吸科的胸外科孤立性肺结节需手术切除患者51例,根据术后病理将孤立性肺结节患者分为肺癌组35例、非肺癌组16例,同期体检者12例为对照组。所有患者均采集呼出气冷凝液、空腹静脉血。采用全自动化学发光免疫分析仪测定CEA水平、酶联免疫吸附试验测定P53蛋白水平、实时荧光定量PCR(real-time fluorescence quantitative PCR,RT-PCR法)测定miRNA21水平,分析呼出气冷凝液CEA、P53蛋白、miRNA21对孤立性肺结节早期肺癌的诊断价值。结果肺癌组EBC的CEA、P53蛋白、miRNA21表达水平均高于非肺癌组与对照组(P<0.05);肺癌组患者EBC中CEA、P53蛋白、miRNA21表达水平与性别、年龄、TNM、病理类型差异均无统计学意义(P>0.05);联合检测EBC的CEA、P53蛋白、miRNA21对孤立性肺结节早期肺癌的诊断敏感性、特异性均优于单项检测(AUC 0,931 P<0.05)。结论联合检测呼出气冷凝液CEA、P53蛋白、miRNA21有助于孤立性肺结节早期肺癌的筛查,提高诊断的敏感性和特异性。Objective To investigate the diagnostic value and clinical correlation of exhaled breath condensate(EBC)carcinoembryonic antigen(CEA),P53 protein and miRNA21 in lung cancer patients.Methods 51 patients with solitary pulmonary nodules in need of surgical incision who were admitted to the department of respiratory medicine and the department of thoracic surgery in our hospital from December 2014 to June 2017 were randomly selected.According to the postoperative pathology,the patients with solitary pulmonary nodules were divided into lung cancer group(n=35),non-lung cancer group(n=16).In the same period,12 cases receiving physical examination were selected as the control group.Exhaled breath condensate and fasting venous blood were collected in all patients.The CEA level was measured by using the automatic chemiluminescence immunoassay analyzer.The level of P53 protein was determined by enzyme-linked immunosorbent assay(ELISA)and the level of miRNA21 was tested by real-time fluorescence quantitative PCR(RT-PCR).The diagnostic value of exhaled breath condensate CEA,P53 protein and miRNA21 in solitary pulmonary nodules in early stage of lung cancer was analyzed.Results The levels of CEA,P53 protein and miRNA21 expression of EBC in lung cancer group were significantly higher than those in non-lung cancer group and control group(P<0.05);the levels of CEA,P53 protein and miRNA21 expression of EBC in lung cancer group were not statisti cally significantly different from those in gender,age,TNM and pathological types(P>0.05);the diagnostic sensitivity and specificity of combined detection of CEA,P53 protein and miRNA21 of EBC in solitary pulmonary nodules in the early stage of lung cancer were better than single detection(AUC 0.931,P<0.05).Conclusion Combined detection of CEA,P53 protein and miRNA21 of EBC is helpful for the screening of solitary pulmonary nodules in the early stage of lung cancer and improve the sensitivity and specificity of diagnosis.

关 键 词：呼出气冷凝液 癌胚抗原 P53蛋白 miRNA21 孤立性肺结节 早期肺癌、诊断价值 相关性 

分 类 号：R734.2[医药卫生—肿瘤]