肺癌骨转移患者血清NTx、BGP、B-AKP水平检测及其临床价值  

Detection of serum NTx,BGP and B-AKP levels in patients with bone metastases from lung cancer and its clinical value

作　　者：马海洋[1] 吴琼[2] 张勇[1] MA Haiyang;WU Qiong;ZHANG Yong(Department of Orthopedics,the People's Hospital of Tangshan,Hebei Tangshan 063000,China;Department of Radiochemical,the People's Hospital of Tangshan,Hebei Tangshan 063000,China)

机构地区：[1]唐山市人民医院骨科,河北唐山063000 [2]唐山市人民医院放化科,河北唐山063000

出　　处：《现代肿瘤医学》2021年第10期1710-1714,共5页Journal of Modern Oncology

摘　　要：目的:探讨肺癌骨转移患者血清Ⅰ型胶原交联氨基末端肽(pyridinoline cross-linked N-telopeptides of type 1 collagen,NTx)、骨钙素(bone gla protein,BGP)、骨性碱性磷酸酶(bone alkaline phophatase,B-AKP)的水平检测及其对肺癌骨转移诊断的临床价值。方法:选取2016年5月至2018年5月我院收治的肺癌骨转移患者108例,肺癌无骨转移患者100例,同时收集肺良性肿瘤者92例。采用酶联免疫法(ELISA)检测患者血清NTx、B-AKP水平,采用电化学发光法(ECL)检测血清BGP水平。比较两组患者血清各检测指标水平;采用Logistic回归模型拟合各指标联合诊断,并建立回归方程;通过受试者工作特征(receiver operating characteristic,ROC)曲线分析各指标及联合诊断价值。结果:骨转移组、无骨转移组和肺良性肿瘤组三组患者血清NTx、BGP和B-AKP差异均有统计学意义(P<0.05)。肺癌骨转移组患者血清上述指标水平均显著高于肺良性肿瘤组和无骨转移组(P<0.05),且肺癌无骨转移组患者血清上述指标水平与肺良性肿瘤组相比显著上升(P<0.05)。血清NTx诊断的临界值为17.14 nmol/L,其对应的灵敏度为73.15%,特异度为64.00%,ROC曲线下面积为0.631(95%CI 0.553~0.709);BGP诊断的临界值为9.33 ng/mL,其对应的灵敏度为75.00%,特异度为69.00%,ROC曲线下面积为0.743(95%CI 0.677~0.809);B-AKP诊断的临界值为18.02μg/L,其对应的灵敏度为64.81%,特异度为75.00%,ROC曲线下面积为0.685(95%CI 0.609~0.761)。在最佳临界切点时,联合检测的灵敏度为90.74%,特异度为72.00%,均高于血清NTx、BGP和B-AKP单独检测。联合诊断的AUC为0.885(95%CI 0.842~0.929)显著高于三种骨代谢指标单独检测(P<0.05)。结论:血清NTx、BGP及B-AKP与骨转移的发病密切相关,三者的单独检测对于骨转移的临床诊断具有重要意义,而联合检测可提高骨转移诊断的灵敏度,对于骨转移的早期诊断提供了一种快速、准确的新方法。Objective:To investigate the serum level of pyridinoline cross-linked N-telopeptides of type 1 collagen(NTx),bone gla protein(BGP),skeletal alkaline phosphate bone alkaline phophatase(B-AKP)and its clinical value in the diagnosis of bone metastases in patients with lung cancer.Methods:A total of 208 patients with lung cancer were enrolled in this study.The patients were divided into two groups according to with or without of bone metastases:108 patients with bone metastasis and 100 patients without bone metastasis.Serum levels of NTx and B-AKP were measured by enzyme-linked immunosorbent assay(ELISA),and serum BGP level was detected by electrochemiluminescence(ECL).The levels of serum were compared between the two groups.Logistic regression model was used to fit the joint diagnosis of each index,and the regression equation was established.The indicators and combined diagnostic value were analyzed by Receiver operating characteristic(ROC)curve.Results:The differences of serum NTx,BGP and B-AKP in three groups,such as bone metastasis group,boneless metastasis group and lung benign tumor group,were statistically significant(P<0.05).The above indexes of serum in lung cancer bone metastasis group were significantly higher than those in lung benign tumor group and boneless metastasis group(P<0.05),and the above index level of serum in patients with lung cancer without bone metastasis group increased significantly compared with that of lung benign tumor group(P<0.05).The optimal critical value of serum NTx diagnosis was 17.14 nmol/L.Its corresponding sensitivity was 73.15%,and the specificity was 64.00%.The AUC was 0.631(95%CI 0.553~0.709).The optimal critical value of BGP diagnosis was 9.33 ng/mL.Its corresponding sensitivity was 75.00%,and the specificity was 69.00%.The AUC was 0.743(95%CI 0.677~0.809).The optimal critical value of B-AKP diagnosis was 18.02μg/L.Its corresponding sensitivity was 64.81%,and the specificity was 75.00%.The AUC was 0.685(95%CI 0.609~0.761).At optimal critical points,the sensitivity of joi

关 键 词：肺癌 骨转移 NTX BGP B-AKP 临床价值 

分 类 号：R734.2[医药卫生—肿瘤]