临床特征联合血清标志物检测预警模型在肺癌骨转移诊断中的临床价值  

Value of clinical features combined with serum marker detection and early warning model in the diagnosis of bone metastasis of lung cancer

作　　者：马海洋[1] 吴琼[2] 张勇[1] MA Hai-yang;WU Qiong;ZHANG Yong(Department of Orthopaedics,Tangshan People's Hospital,Tangshan,Hebei,063000,China)

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

出　　处：《中国骨与关节杂志》2023年第5期351-356,共6页Chinese Journal of Bone and Joint

基　　金：河北省卫生厅科研基金项目(20181209)。

摘　　要：目的 探究肺癌患者临床基线资料特征联合糖链抗原125 (CA125)、癌胚抗原(CEA)、Ⅰ型胶原交联羧基端(C端)肽(CTx)、骨特异性碱性磷酸酶(bALP)、Ⅰ型原胶原氨基端(N端)延长肽(PINP)、外周血循环肿瘤细胞(CTC)等血清标志物构建骨转移预警模型及其预测骨转移的价值。方法 收集本院肿瘤科在2018年6月至2020年5月经治的206例肺癌骨转移患者临床资料进行回顾性分析。收集患者的血清标志物水平,检测方法为电化学发光免疫分析法(ECLIA),对比骨转移组和无骨转移组的临床资料以及血清标志物结果差异,根据Logistic回归分析肺癌患者骨转移的结果构建组合模型,采用ROC曲线分析其对肺癌骨转移的诊断性能。结果 相比于无骨转移组,骨转移组的骨显像阳性检出率明显升高(P <0.001);相比于无骨转移组,骨转移组的血清标志物CTC、CEA、CA125、PINP、bALP、CTx水平明显升高(P <0.001);相比于无骨转移组,骨转移组的临床分期、腺癌比例明显升高(P <0.05);肺癌骨转移应用临床特征联合血清标志物肺癌骨转移预测模型诊断的准确率为92.23%,AUC为0.916。结论 CTC、CEA、CA125、PINP、bALP为肺癌患者发生骨转移的危险因素。肺癌患者骨转移的临床特征以及血清标志物指标构建预警模型,在肺癌骨转移的临床诊断以及骨转移预测中具有一定的辅助诊断价值。Objective To explore the clinical baseline data characteristics of lung cancer patients combined with glycochain antigen 125(CA125),carcinoembryonic antigen(CEA),typeⅠcollagen crosslinked carboxyterminal(C-terminal)peptide(CTx),bone-specific alkaline phosphatase(bALP),typeⅠprotocollagen aminoterminal(N-terminal)elongating peptide(PINP),peripheral blood circulating tumor cells(CTC)and other serum markers to construct an early warning model of bone metastasis and their value in predicting bone metastasis.Methods The clinical data of 206 patients with bone metastasis of lung cancer treated in the Department of Oncology of our hospital from June 2018 to May 2020 were retrospectively analyzed and followed up.Serum marker level was collected.Electrochemical luminescence immunoassay(ECLIA)was applied for detection.Clinical data and serum marker differences between the bone-metastasis group and non bone-metastasis group were analyzed.Logistic regression analysis was used to build a portfolio model.ROC curve analysis was used to detect its performance to the diagnose bone metastases with lung cancer.Results Compared with the group without bone metastasis,the positive rate of bone imaging significantly increased in the group with bone metastasis(P 0.001);Compared with the group without bone metastasis,serum markers CTC,CEA,CA125,PINP,bALP and CTx levels significantly increased in the group with bone metastasis(P 0.001);Compared with the group without bone metastasis,the clinical stage and adenocarcinoma proportion significantly increased in the group with bone metastasis(P 0.05);CTC,CEA,CA125,PINP and bALP were risk factors for bone metastasis in lung cancer patients.The accuracy of the prediction model of lung cancer bone metastasis using clinical features combined with serum markers was 92.23%,and the AUC was 0.914.Conclusions According to Logistis regression analysis of clinical characteristics of bone metastasis in lung cancer patients and serum marker indicators,the establishment of early warning model has certain

关 键 词：预警评分 肺肿瘤 肿瘤转移 骨肿瘤 血清标志物 

分 类 号：R738.1[医药卫生—肿瘤]