血清骨代谢标志物在肺癌骨转移诊断、疗效评估及预后预测中的应用价值  

Application value of bone metabolism indexes in the diagnosis,evaluation and prognosis of bone metastasis of lung cancer

作　　者：陈柏竹 毛建华 徐响瑜 王磊 CHEN Bai-zhu;MAO Jian-hua;XU Xiang-yu;WANG Lei(Pneumology Department,Quzhou Hospital of Traditional Chinese Medicine,Quzhou,Zhejiang 324000,China)

机构地区：[1]衢州市中医医院呼吸科,浙江衢州324000 [2]衢州市中医医院肿瘤科,浙江衢州324000

出　　处：《中国卫生检验杂志》2022年第4期453-456,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨血清骨代谢标志物碱性磷酸酶(ALP)、骨钙素N端中分子片段(N-MID)、总I型前胶原氨基端前肽(TPINP)在肺癌骨转移诊断、疗效评估及预后预测中的价值。方法回顾性分析2017年3月—2020年6月衢州市中医医院收治的98例肺癌患者的临床资料,将45例肺癌无骨转移患者纳入无骨转移组,53例肺癌伴骨转移患者纳入骨转移组,选取同期50例健康体检者作为对照组。比较所有研究对象治疗前ALP、N-MID、TPINP水平以及治疗后肺癌患者ALP、N-MID、TPINP水平变化,采用ROC曲线下面积(AUC)对不同骨代谢指标诊断肺癌骨转移的价值进行比较,并观察不同临床疗效患者的骨代谢指标水平以及不同骨代谢指标水平肺癌患者的生存情况。结果治疗前肺癌患者ALP、N-MID、TPINP水平明显高于对照组(P<0.05),且骨转移组明显高于无骨转移组(P<0.05);ALP、N-MID、TPINP诊断肺癌患者骨转移的AUC分别为0.727、0.725、0.895,TPINP诊断AUC明显大于ALP、N-MID(P<0.05),ALP、N-MID、TPINP诊断最佳临界值分别为95.28 U/L、16.56μg/L和69.94μg/L;治疗后有效组患者ALP、N-MID、TPINP水平较治疗前明显下降(P<0.05),且有效组患者ALP、N-MID、TPINP水平明显低于无效组(P<0.05);TPINP≥69.94μg/L患者的预后情况明显差于TPINP<69.94μg/L患者,上述差异均有统计学意义(P<0.05)。结论ALP、N-MID、TPINP均可作为肺癌骨转移诊断、疗效评估的有效指标,TPINP还可用于肺癌患者的预后评估。Objective To explore the application value of bone metabolism indexes,alkaline phosphatase(ALP),N-terminal-mid fragment of osteocalcin(N-MID)and total procollagen type 1 N-terminal peptide(TPINP)in the diagnosis,evaluation and prognosis of bone metastasis of lung cancer.Methods The clinical data of 98 patients with lung cancer admitted to Quzhou City Hospital of Traditional Chinese Medicine from March 2017 to October 2020 were retrospectively analyzed.45 cases without bone metastasis were included in the non-bone metastasis group,and 53 patients with bone metastasis were included in the bone metastasis group.At the same time,50 healthy people were selected as the control group.The levels of ALP,N-MID and TPINP in all subjects before treatment and the levels of bone metabolic indexes in patients with lung cancer after treatment were observed.The value of bone metastasis in patients with lung cancer was compared by using the area under ROC curve(AUC),and the level of bone metabolism in patients with different clinical efficacy and the survival of bone metabolic in patients with different indexes were observed.Results The levels of ALP,N-MID and TPINP in patients with lung cancer before treatment were significantly higher than those in the control group(P<0.05),and the levels of ALP,N-MID and TPINP in bone metastasis group were significantly higher than that in non-bone metastasis group(P<0.05).The AUC of ALP,N-MID and TPINP diagnosed lung cancer patients was 0.727,0.725,0.895,and the AUC of TPINP was significantly higher than those of ALP and N-MID(P<0.05).The optimal thresholds of ALP,N-MID and TPINP were 95.28 U/L,16.56μg/L and 69.94μg/L.After treatment,the levels of ALP,N-MID and TPINP in effective group were significantly lower than those before treatment(P<0.05),and the levels of ALP,N-mid and TPINP in effective group were significantly lower than those in ineffective group(P<0.05).The prognosis of patients with TPINP≥69.94μg/L was significantly worse than that of patients with TPINP<69.94μg/L,with the a

关 键 词：肺癌 骨转移 碱性磷酸酶 骨钙素N端中分子片段 总I型前胶原氨基端前肽 诊断 疗效 预后 

分 类 号：R734.2[医药卫生—肿瘤]