人附睾蛋白4在肺癌患者血清中的表达及应用价值  

Expression and application value of human epididymis protein 4 in serum of patient with lung cancer

作　　者：刘兆宇 李岩[2] 程菲[1] 张自豪 张晓[1] 肖征[1] 胡红焱 LIU Zhaoyu;LI Yan;CHENG Fei;ZHANG Zihao;ZHANG Xiao;XIAO Zheng;HU Hongyan(Clinical Laboratory,Hainan Branch of PLA General Hospital,Hainan Sanya 572013,China;Blood Transfusion Department,Hainan Branch of PLA General Hospital,Hainan Sanya 572013,China.)

机构地区：[1]解放军总医院海南医院检验中心,海南三亚572013 [2]解放军总医院海南医院输血科,海南三亚572013

出　　处：《现代肿瘤医学》2021年第12期2071-2075,共5页Journal of Modern Oncology

基　　金：海南省自然科学基金青年项目(编号:819QN377)。

摘　　要：目的:通过检测人附睾蛋白4(HE4)在肺癌患者血清中的表达水平,并与指南推荐的五种肺癌肿瘤标志物对比,探讨其在肺癌诊疗过程中的临床应用价值。方法:选取378例肺癌患者(肺癌组)、208例肺部良性疾病患者(良性疾病对照组)、102例健康查体者(健康对照组)为研究对象,用电化学发光法检测血清人附睾蛋白4(HE4)、癌胚抗原(CEA)、细胞角蛋白片段19(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、胃泌素释放肽前体(ProGRP)和鳞状上皮细胞癌抗原(SCC),各组间进行比较,采用受试者工作特征(ROC)曲线分析HE4、CEA、CYFRA21-1、NSE、ProGRP、SCC及曲线下面积(AUC),比较各血清标志物诊断肺癌的敏感性、特异性。结果:肺癌组血清HE4水平显著高于良性疾病组(P<0.01),非小细胞肺癌(NSCLC)组和小细胞肺癌(SCLC)组间HE4水平无差异(P>0.05)。不同病理类型肺癌患者血清CEA、SCC、CYFRA21-1表达有差异(均P<0.05),HE4水平无统计学差异(P>0.05)。NSCLC组中,临床分期级别越高,HE4表达水平越高(P<0.05);SCLC组中,HE4在局限期和广泛期患者中表达无统计学差异(P>0.05)。CYFRA21-1、HE4与肿瘤直径呈正相关(P<0.01),相关系数分别为0.222和0.547。应用HE4诊断肺癌时,其cut-off值为77.35 pmol/L,AUC为0.8737,敏感性为86.95%,高于指南推荐的其他五种标志物。结论:HE4可作为肺癌辅助诊断的血清标志物之一,其对评估肺癌患者的疾病进展有一定的临床应用价值。Objective:To investigate the clinical application value of human epididymal protein 4(HE4)in the diagnosis and treatment of lung cancer by comparing the expression level of human epididymal protein 4(HE4)in the serum of lung cancer patients with five lung cancer tumor markers recommended by the guidelines.Methods:378 patients with lung cancer(lung cancer group),208 patients with benign lung disease(control group with benign disease),and 102 healthy subjects(healthy control group)were selected as the research subjects.The electrochemical luminescence method detected serum human epididymal protein 4(HE4),carcinoembryonic antigen(CEA),cytokeratin fragment 19(CYFRA21-1),neuron-specific enolase(NSE),gastrin-releasing peptide precursor(ProGRP),and squamous cell carcinoma antigen(SCC).Receiver operating characteristic(ROC)curve analysed HE4,CEA,CYFRA21-1,NSE,ProGRP,SCC,and area under the curve(AUC).Sensitivity and specificity of each serum marker to diagnose lung cancer were compared.Results:Serum HE4 levels in lung cancer group were significantly higher than those in benign disease group(P<0.01).There was no difference in HE4 levels between non-small cell lung cancer(NSCLC)group and small cell lung cancer(SCLC)group(P>0.05).There were differences in serum CEA,SCC,and CYFRA21-1 expressions in patients with different types of lung cancer(all P<0.05),and HE4 levels were not statistically significant(P>0.05).In the NSCLC group,the higher the clinical staging level,the higher the expression level of HE4(P<0.05).In the SCLC group,there was no statistical difference in the expression of HE4 in patients with limited and extensive stages(P>0.05).CYFRA21-1 and HE4 were positively correlated with tumor diameter(P<0.01),with correlation coefficients of 0.222 and 0.547.When HE4 was used to diagnose lung cancer,the cut-off value was 77.35 pmol/L.The AUC was 0.8737,and the sensitivity was 86.95%,which was higher than the other five markers recommended by the guidelines.Conclusion:HE4 can be used as one of the serum markers for the au

关 键 词：人附睾蛋白4 肺癌 肿瘤标志物 

分 类 号：R734.2[医药卫生—肿瘤]