PET/CT联合血清HE4、ESM-1在肺癌诊断中的应用价值  

Application value of PET/CT combined with the detection of serum levels of HE4 and ESM-1 in diagnosis of lung cancer

作　　者：裴家强[1] 游波[1] 游凯 吴蔚 PEI Jiaqiang;YOU Bo;YOU Kai(Department of Cardiothoracic Surgery,No. 958 Hospital of PLA,Chongqing 400020,China)

机构地区：[1]中国人民解放军陆军第958医院心胸外科,重庆市400020 [2]陆军军医大学附属西南医院胸外科

出　　处：《河北医药》2020年第14期2125-2128,共4页Hebei Medical Journal

基　　金：重庆市卫生和计划生育委员会科研基金项目(编号:2016MSXM215)。

摘　　要：目的检测PET/CT联合血清人附睾蛋白4(HE4)、内皮细胞特异性分子-1(ESM-1)在肺癌诊断中的应用价值。方法选择2016年2月至2019年1月治疗的肺癌患者80例为肺癌组,肺良性病变患者55例为肺良性病变组,另选择60例健康体检者为健康组;对研究对象进行PET/CT全身扫描,采集研究对象的空腹静脉血5 ml,电化学发光法检测血清HE4水平,ELISA法检测血清ESM-1水平;绘制血清HE4、ESM-1的受试者工作特征(receiver operator characteristic,ROC)曲线,评价其对肺癌的诊断价值。结果PET/CT检查显示,65例肺部患者显示FDG异常放射性浓聚,其中小细胞癌3例,大细胞癌4例,黏液表皮样癌2例,周围型腺癌14例,腺癌20例,鳞癌22例;55例良性患者中,PET/CT检测显示8例为肺癌,PET/CT检测的敏感性、特异性、符合率分别为89.04%、75.80%、81.25%;各组血清HE4、ESM-1水平具有显著差异,肺癌组血清HE4、ESM-1水平高于肺良性病变组和健康对照组(P<0.05),肺良性病变组血清HE4、ESM-1水平高于健康对照组(P<0.05);ROC曲线分析显示,血清HE4、ESM-1诊断肺癌的曲线下面积分别为0.902、0.922,诊断分界点分别为70 ng/ml、26.69 ng/ml,敏感性分别为82.5%、88.7%,特异性分别为91.55%、90.95%,准确性分别为84.56%、83.12%;血清HE4、ESM-1联合检测的AUC曲线下面积为0.955,敏感性为90.00%,特异性为92.70%、准确性为86.06%;PET/CT联合血清HE4、ESM-1检测的敏感性为92.50%,特异性为94.80%、准确性为88.25%,单项指标检测结果中,PET/CT检测的敏感度最高,血清HE4检测的特异度最高,二者联合和三者联合检测的敏感度、特异度、准确度均高于单项指标检测,且三者联合检测高于二者联合。结论PET/CT和血清HE4、ESM-1单独检测对肺癌均有一定的诊断价值,联合检测可显著提高诊断的敏感性和特异性。Objective To investigate the application value of PET/CT combined with the detection of serum levels of human epididymal protein 4(HE4)and endothelial cell specific molecule-1(ESM-1)in diagnosis of lung cancer.Methods A total of 80 patients with lung cancer who were treated in our hospital from February 2016 to January 2019 were enrolled as lung cancer group,and 55 patients with benign lung lesions were enrolled as benign lung lesion group,and the other 60 healthy subjects who underwent physical examination in our hospital were enrolled as control group.All the subjects underwent PET/CT whole body scanning,and fasting venous blood speciments(5ml)were collected from all the subjects.The serum levels of HE4 were detected by electrochemiluminescence,the serum levels of ESM-1 were detected by ELISA,moreover,the receiver operator characteristic(ROC)curves of serum HE4 and ESM-1 were drawn to evaluate its diagnostic value for lung cancer.Results PET/CT showed that abnormal radioactivity concentration of FDG was observed in 65 patients with lung disease,including 3 cases of small cell carcinoma,4 cases of large cell carcinoma,2 cases of mucoepidermoid carcinoma,14 cases of peripheral adenocarcinoma,20 cases of adenocarcinoma and 22 cases of squamous cell carcinoma.Among the 55 patients with benign lung lesions,PET/CT examination confirmed that there were 8 cases of lung cancer,the sensitivity,specificity and coincidence rates of PET/CT were 89.04%,75.80%and 81.25%respectively.There were significant differences in serum levels of HE4 and ESM-1 among groups,the serum levels of HE4 and ESM-1 in lung cancer group were significantly higher than those in benign lung lesion group and control group(P<0.05),and the serum levels of HE4 and ESM-1 in benign lung lesion group were significantly higher than those in control group(P<0.05).ROC curve analysis showed that the area underthe curve of serum HE4 and ESM-1 in diagnosis oflung cancer was 0.902 and 0.922,respectively,thediagnostic boundary point was 70ng/ml and 26.69ng/ml,respe

关 键 词：PET/CT 血清人附睾蛋白4 内皮细胞特异性分子-1 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]