血清碱性磷酸酶、Ⅰ型前胶原氨基端前肽与Ⅰ型胶原羧基端肽β特殊序列在恶性肿瘤骨转移诊断中的应用价值  

Application value of serum alkaline phosphatase, N-terminal propeptide of type Ⅰ collagen and β- cross-linked C-telopeptide of type Ⅰ collagen in the diagnosis of bone metastasis of malignant tumor

作　　者：王蒙蒙 朱丽英[1] 李晓利 任萍[1] 赵变峰[1] 谢凤利 WANG Mengmeng;ZHU Liying;LI Xiaoli;REN Ping;ZHAO Bianfeng;XIE Fengli(Department of Oncology,the Second Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Department of Imaging,the Second Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第二附属医院肿瘤内科,河南洛阳471000 [2]河南科技大学第二附属医院影像科,河南洛阳471000

出　　处：《肿瘤基础与临床》2021年第5期385-388,共4页journal of basic and clinical oncology

基　　金：河南省医学科技攻关计划项目(2018020921)。

摘　　要：目的探讨血清碱性磷酸酶(ALP)、Ⅰ型前胶原氨基端前肽(PINP)与Ⅰ型胶原羧基端肽β特殊序列(β-CTX)在恶性肿瘤骨转移诊断中的临床价值。方法选取2019年1月至2020年5月河南科技大学第二附属医院收治的76例晚期恶性肿瘤骨转移患者(骨转移组)和72例无骨转移的晚期恶性肿瘤患者(无骨转移组),比较2组患者血清ALP、PINP和β-CTX水平,以及三者单独及联合检测对恶性肿瘤骨转移的诊断效能。结果骨转移组患者血清ALP、PINP和β-CTX水平分别为(284.19±70.40)u/L、(120.86±24.29)ng/mL、(0.89±0.62)ng/mL,均明显高于无骨转移组的(253.25±67.34)u/L、(84.63±30.98)ng/mL、(0.44±0.27)ng/mL,差异均有统计学意义(t=2.730,P=0.007;t=7.892,P<0.001;t=5.831,P<0.001)。ALP诊断恶性肿瘤骨转移的敏感性为083、特异性为0.64、曲线下面积为0.67,PINP分别为0.90、0.74、0.81,β-CTX分别为0.76、0.78、0.78,三者联合检测分别为0.84、0.96、0.89。结论血清ALP、PINP和β-CTX对恶性肿瘤骨转移具有较高的诊断价值,对临床有重要应用价值,联合检测的诊断价值优于单项检测,为恶性肿瘤骨转移的早期诊断提供一种简单有效的诊断方法。Objective To investigate the clinical value of serum Alkaline phosphatase(ALP),N-terminal propeptide of typeⅠcollagen(PINP)andβ-cross-linked C-telopeptide of typeⅠcollagen(β-CTX)in the diagnosis of bone metastasis of advanced malignant tumor.Methods From January 2019 to May 2020,76 malignant tumor patients with bone metastasis(the bone metastasis group)and 72 malignant tumor patients without bone metastasis(the no bone metas-tasis group)were selected in the Second Affiliated Hospital of Henan University of Science and Technology.The serum ALP,PINP andβ-CTX levels were compared between the two groups,as well as the diagnostic efficacy of single and combined detection of the three indexes for bone metastasis of advanced malignant tumor.Results The serum levels of ALP,PINP andβ-CTX in the bone metastasis group[(284.19±70.40)u/L,(120.86±24.29)ng/mL,(0.89±0.62)ng/mL]were significantly higher than those in the on bone metastasis group[(253.25±67.34)u/L,(84.63±30.98)ng/mL,(0.44±0.27)ng/mL;t=2.730,P=0.007;t=7.892,P<0.001;t=5.831,P<0.001].The sensitivity,specificity and area under curve of ALP in the diagnosis of bone metastasis of malignant tumor were 0.83,0.64 and 0.67 respectively;those of PINP were 0.90,0.74 and 0.81;those ofβ-CTX were 0.76,0.78 and 0.78;those of the combined detection were 0.84,0.96 and 0.89.Conclusion The Serum levels of ALP,PINP andβ-CTX have the high diagnostic value for bone metastasis of malignant tumor,the diagnostic value of combined detection is better than the single detection,and can provide a simple and effective diagnostic method for the early diagnosis of bone metastasis of malignant tumor.

关 键 词：恶性肿瘤 骨转移 碱性磷酸酶 Ⅰ型前胶原氨基端前肽 Ⅰ型胶原羧基端肽β特殊序列 

分 类 号：R730.6[医药卫生—肿瘤]