血清PCNA、TIMP-1水平检测联合SPECT检查对肺癌骨转移的诊断价值  

Diagnostic value of serum levels of PCNA,TIMP-1 combined with SPECT in lung cancer with bone metastasis

作　　者：吾热丽卡・艾力 迪力夏提・依明 Wurelika Aili;Dilixiati Yiming(Imaging Center,Kashgar Prefecture Second People's Hospital,Kashgar 844000,China)

机构地区：[1]新疆维吾尔自治区喀什地区第二人民医院影像中心,844000

出　　处：《中国医师杂志》2021年第2期211-214,222,共5页Journal of Chinese Physician

摘　　要：目的探讨血清中增殖细胞核抗原(PCNA)、组织金属蛋白酶抑制剂1(TIMP-1)水平检测联合单光子发射型计算机断层扫描(SPECT)检查对肺癌骨转移的诊断价值。方法回顾性分析2017年2月至2019年8月喀什地区第二人民医院收治的原发性肺癌骨转移患者(观察组,82例)及原发性肺癌非骨转移患者(对照组,82例)的病例资料。采用酶联免疫吸附试验(ELISA)检测血清PCNA、TIMP-1水平;采用SPECT仪检查受试者全身骨转移情况;采用Pearson法分析血清PCNA、TIMP-1水平与SPECT骨显像分级的相关性。绘制受试者工作特征曲线,分析SPECT检查及血清PCNA、TIMP-1水平检测对肺癌骨转移的诊断价值;以MRI检查为金标准,采用四格表分析SPECT检查联合血清PCNA、TIMP-1水平检测对肺癌骨转移的诊断价值。结果与对照组比较,观察组血清PCNA、TIMP-1水平均明显更高(P<0.05),且随着疾病严重程度(EOD)等级增加血清PCNA、TIMP-1水平升高(P<0.05)。血清PCNA、TIMP-1检测诊断肺癌骨转移的AUC分别为0.835(95%CI:0.771~0.898)、0.814(95%CI:0.746~0.882),截断值分别为388.76 pg/ml、524.45 pg/ml,灵敏度分别为82.70%、79.00%,特异度分别为74.40%、76.80%。SPECT检出肺癌骨转移的灵敏度为82.93%,特异度为90.24%。血清PCNA、TIMP-1检测联合SPECT检查诊断肺癌骨转移的灵敏度为95.12%,特异度为91.46%,高于血清PCNA、TIMP-1检测及SPECT单独检测。结论血清PCNA、TIMP-1水平升高与肺癌骨转移及其严重程度有关,联合SPECT检查对肺癌骨转移的诊断价值较高。Objective To investigate the diagnostic value of serum proliferating cell nuclear antigen(PCNA),tissue metalloproteinase inhibitor-1(TIMP-1)levels combined with single photon emission computed tomography(SPECT)in lung cancer bone metastasis.Methods 82 patients with bone metastasis of primary lung cancer(observation group)and 82 patients without bone metastasis(control group)in Kashgar Prefecture Second Peopled Hospital from February 2017 to August 2019 were retrospectively analyzed.The levels of PCNA and TIMP-1 in serum were detected by enzyme-linked immunosorbent assay(ELISA);bone metastasis were detected by SPECT;Pearson method was used to analyze the correlation between serum PCNA,TIMP-1 levels and SPECT bone imaging grade;The diagnostic value of SPECT and serum levels of PCNA and TIMP-1 in bone metastasis of lung cancer was analyzed by drawing the receiver operating characteristic curve;the diagnostic value of SPECT combined with serum levels of PCNA and TIMP-1 in bone metastasis of lung cancer was analyzed by four grid table with magnetic resonance imaging(MRI)as the gold standard.Results Compared with the control group,the serum levels of PCNA and TIMP-1 in the observation group were significantly higher(P<0.05),and increased with the increase of the extend of disease(EOD)grade(P<0.05).The AUC of serum PCNA and TIMP-1 levels in the diagnosis of bone metastasis of lung cancer were 0.835(95%CI:0.771-0.898)and 0.814(95%CI:0.746-0.882),respectively.When cutoff values were 388.76 pg/ml and 524.45 pg/ml,the sensitivity were 82.70%,79.00%,and the specificity were 74.40%,76.80%,respectively.The sensitivity and specificity of SPECT were 82.93%and 90.24%respectively.The sensitivity and specificity of serum PCNA,TIMP-1 levels combined with SPECT in the diagnosis of bone metastasis of lung cancer were 95.12%and 91.46%,respectively,which were higher than those of serum PCNA,TIMP-1 levels and SPECT alone.Conclusions Increased serum PCNA and TIMP-1 levels are related to bone metastasis of lung cancer and its severity.Comb

关 键 词：肺肿瘤 肿瘤转移 骨疾病 单光子发射计算机体层摄影术 增殖细胞核抗原 金属蛋白酶1组织抑制剂 

分 类 号：R734.2[医药卫生—肿瘤]