血清钙离子、ALP及CYFRA21-1对肺癌早期骨转移的预测价值  

Predictive value of serum calcium ions,ALP and CYFRA21-1 for early bone metastases of lung cancer

作　　者：赵车冬 徐倩 马婧 张键[3] ZHAO Chedong;XU Qian;MA Jing;ZHANG Jian(Department of Clinical Laboratory,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shanxi,China,710061;Department of Clinical Laboratory,Xi'an Fourth hospital,Xi'an,Shanxi,China,710004;Department of Dermatology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shanxi,China,710061)

机构地区：[1]西安交通大学第一附属医院检验科,陕西西安710061 [2]西安市第四医院检验科,陕西西安710004 [3]西安交通大学第一附属医院皮肤科,陕西西安710061

出　　处：《分子诊断与治疗杂志》2020年第10期1323-1327,共5页Journal of Molecular Diagnostics and Therapy

基　　金：西安交通大学第一附属医院院科研发展项目(YK201522)。

摘　　要：目的分析血清钙离子、碱性磷酸酶(ALP)及细胞角蛋白19片段抗原21-1(CYFRA21-1)对肺癌早期骨转移的预测价值。方法研究对象为本院肿瘤内科自2017年1月至2019年7月收治的肺癌患者,根据骨转移情况分为骨转移组和无骨转移组,骨转移组根据转移程度分为单发骨转移和多发骨转移两个亚组。采集所有受试者晨间空腹静脉血检测血清钙离子、ALP、CYFRA21-1水平;绘制受试者工作特征(ROC)曲线分析血清钙离子、ALP、CYFRA21-1对肺癌早期骨转移的预测价值。结果127例肺癌患者骨转移发生率为44.88%(57/127),其中腺癌骨转移发生率显著高于鳞癌、小细胞癌、腺鳞癌,差异具有统计学意义(P<0.05),但鳞癌、小细胞癌、腺鳞癌之间骨转移发生率比较差异无统计学意义(P>0.05);肺癌骨转移患者血清钙离子、ALP、CYFRA21-1均显著高于肺癌无骨转移患者,差异具有统计学意义(P<0.05),且多发骨转移患者血清钙离子、ALP、CYFRA21-1显著高于单发骨转移患者,差异具有统计学意义(P<0.05),单一指标预测时,ALP的曲线下面积(AUC)值最高以>95.23 U/L为临界值,其预测肺癌早期骨转移的敏感度、特异度分别为57.89%、70.00%;联合预测AUC值上升至0.765,并显著高于单一血清钙离子、ALP及CYFRA21-1,以>0.459为临界值,其预测肺癌早期骨转移的灵敏度、特异度分别为70.18%、70.00%。结论单一血清钙离子、ALP及CYFRA21-1预测肺癌早期骨转移时效能欠佳,但联合预测可提升诊断效能,可联合用于肺癌骨转移的早期预警。Objective To analyze the predictive value of serum calcium ions,alkaline phosphatase(ALP)and cytokeratin 19 fragment 21-1(CYFRA21-1)for bone metastases of lung cancer.Methods Between January 2017 and July 2019,fasting venous blood samples were collected from lung cancer patients treated in the Department of Oncology of our hospital.The serum levels of calcium ion,ALP and CYFRA21-1 were measured.The incidence of bone metastasis in lung cancer patients with different pathological types was compared.The incidences of bone metastases in patients with different pathological types of lung cancer were compared.Serum levels of calcium ion,ALP and CYFRA21-1 were compared between patients with and without bone metastasis,and patients with different degrees of bone metastases.The receiver operating characteristic(ROC)curves were used to analyze the predictive value of serum calcium ion,ALP and CYFRA21-1 in bone metastases from lung cancer.Results The incidence of bone metastases in this study was 44.88%(57/127).The incidence of bone metastases from adenocarcinoma was significantly higher than those from squamous cell carcinoma,small cell carcinoma and adenosquamous carcinoma.However,there were no significant differences in the incidences of bone metastases from squamous cell carcinoma,small cell carcinoma and adenosquamous carcinoma(P>0.05).Serum levels of calcium ion,ALP and CYFRA21-1 were significantly higher in lung cancer patients with bone metastasis than in those without bone metastasis(P<0.05),and significantly higher in patients with multiple bone metastases than in those with single bone metastasis(P<0.05).In terms of single index diagnosis,the area under the curve(AUC)of ALP was the largest,with>95.23 U/L as the cut-off value.And its sensitivity and specificity for predicting bone metastases from lung cancer were 57.89%and 70.00%.The AUC of combined prediction was 0.765,significantly larger than that of each index single prediction(P<0.05).With>0.459 as the cut-off value,the sensitivity and specificity for predict

关 键 词：血清钙离子 碱性磷酸酶 细胞角蛋白19片段抗原21-1 肺癌 骨转移 

分 类 号：R734.2[医药卫生—肿瘤]