系统免疫炎症指数和肿瘤标志物与肺癌骨转移的相关性  

Correlation of Systemic Immune Inflammatory Index and Tumor Markers with Bone Metastasis of Lung Cancer

作　　者：唐敏 李桂香[1] TANG Min;LI Guixiang(Cancer Center,The Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院肿瘤中心,兰州730030

出　　处：《肿瘤防治研究》2022年第12期1252-1257,共6页Cancer Research on Prevention and Treatment

摘　　要：目的评估肺癌患者治疗前系统免疫炎症指数(SII)、肺癌肿瘤标志物CEA、Cyfra21-1、NSE对肺癌骨转移的预测及诊断价值。方法回顾性分析618例肺癌患者临床资料,根据基线时是否骨转移,对诊断组(基线时已经发生骨转移患者和随访未发生骨转移患者)与预测组(随访发生骨转移患者与随访未发生骨转移患者)进行数据分析,确定上述指标与肺癌骨转移的相关性。结果预测组:Logistic单因素分析显示SII≥850、NSE≥58.64 ng/ml是肺癌骨转移的独立危险因素和独立预测因素。SII+NSE组合模型曲线下面积为0.662,敏感度为54.5%,特异性为74.5%,优于单一因素预测价值(95%CI:0.596-0.728,P<0.001)。诊断组:Logistic回归分析结果显示肺腺癌、SII≥951.6、CEA≥5.14 ng/ml、NSE≥20.15 ng/ml、Cyfra21-1≥3.94 ng/ml是肺癌患者发生骨转移的独立危险因素(P<0.05),SII单独诊断肺癌骨转移的曲线下面积为0.754,SII+Cyfra21-1组合模型曲线下面积最大,AUC为0.82,敏感度为74%,特异性为78.5%,并优于任何单因素曲线下面积(P<0.05)。结论SII、CEA、Cyfra21-1、NSE在骨转移组水平均显著高于非骨转移组,当SII联合其他单一危险因素时,预测价值及诊断价值进一步提高。Objective To evaluate the value of the systemic immune-inflammatory index(SII),CEA,Cyfra21-1,and NSE in predicting and diagnosing bone metastasis of lung cancer.Methods The clinical data of 618 patients with lung cancer were retrospectively analyzed.According to the bone metastasis at baseline,the data of the diagnosis group(patients with bone metastasis at baseline and patients without bone metastasis during follow-up)and the prediction group(patients with bone metastasis during follow-up and patients without bone metastasis during follow-up)were analyzed to determine the correlation between the above indicators and lung cancer bone metastasis.Results Predictive group:SII≥850 and NSE≥58.64 ng/ml were independent risk factors and independent predictors for lung cancer bone metastasis.The AUC of the combined SII+NSE model was 0.662,with a sensitivity of 54.5%and a specificity of 74.5%;it was superior to the predictive value of single factor(95%CI:0.596-0.728;P<0.001).Diagnostic group:lung adenocarcinoma,SII≥951.6,CEA≥5.14 ng/ml,NSE≥20.15 ng/ml,and Cyfra21-1≥3.94 ng/ml were independent risk factors for bone metastasis in lung cancer patients(P<0.05).The AUC of SII alone in the diagnosis of lung cancer bone metastasis was 0.754.The AUC of the SII+Cyfra21-1 combined model was 0.82 which was the largest,with a sensitivity of 74%and a specificity of 78.5%;it was superior to any univariate AUC(P<0.05).Conclusion The levels of SII,CEA,Cyfra21-1,and NSE in the bone metastasis group are significantly higher than those in the non-bone metastasis group.The predictive and diabnostic values would be improved further when SII combined with other single risk factors.

关 键 词：肺癌 骨转移 系统免疫炎症指数 危险因素 肿瘤标志物 

分 类 号：R734.2[医药卫生—肿瘤]