血清N-端骨钙素和细胞角蛋白5/6在原发性肺癌骨转移患者中的表达及其临床意义  

Expressions of serum N-terminal osteocalcin and cytokeratin 5/6 in primary lung cancer patients with bone metastasis and their clinical significances

作　　者：苟冶然 徐治波[1] 林家晨 文艳梅[1] 邓正旭[1] Gou Yeran;Xu Zhibo;Lin Jiachen;Wen Yanmei;Deng Zhengxu(Department of Respiratory and Critical Care Medicine,Chengdu Second People's Hospital,Chengdu 610000,China)

机构地区：[1]成都市第二人民医院呼吸与危重症医学科,成都610000

出　　处：《肿瘤研究与临床》2023年第5期366-370,共5页Cancer Research and Clinic

摘　　要：目的探讨原发性肺癌骨转移患者中血清N-端骨钙素(N-MID)、细胞角蛋白(CK)5/6的表达及其临床意义。方法回顾性分析2019年2月至2022年2月成都市第二人民医院收治的96例原发性肺癌患者临床资料,根据是否发生骨转移分为骨转移组(38例)和非骨转移组(58例),另选取同期45名健康体检者作为健康对照组。比较3组间血清N-MID、CK5/6表达水平。采用logistic回归分析原发性肺癌患者骨转移的影响因素。采用受试者工作特征(ROC)曲线分析血清N-MID、CK5/6表达水平对原发性肺癌患者骨转移的预测价值。结果骨转移组病理分期Ⅲ~Ⅳ期患者构成比、血清骨源性碱性磷酸酶及N-MID表达水平均高于非骨转移组(均P<0.05)。骨转移组和非骨转移组血清N-MID表达水平均高于健康对照组[(26.0±5.3)ng/ml、(15.3±3.1)ng/ml比(9.9±1.7)ng/ml,F=224.27,P<0.001],且3组间两两比较,差异均有统计学意义(均P<0.05)。骨转移组和非骨转移组血清CK5/6表达水平均低于健康对照组[(3.6±0.7)ng/ml、(7.3±1.4)ng/ml比(10.6±2.4)ng/ml,F=178.11,P<0.001],且3组间两两比较,差异均有统计学意义(均P<0.05)。多因素分析结果显示,N-MID、CK5/6、骨源性碱性磷酸酶均为原发性肺癌患者骨转移的独立影响因素(OR值分别为4.088、3.615、2.892,均P<0.05)。ROC曲线分析显示,血清N-MID、CK5/6表达水平预测原发性肺癌患者骨转移的最佳临界值分别为18.59、4.71 ng/ml,曲线下面积(AUC)分别为0.881、0.862,两者联合预测原发性肺癌骨转移的特异度和AUC分别为98.28%和0.937(95%CI 0.869~0.977),两者联合预测的AUC大于两者单独预测(均P<0.001)。结论原发性肺癌骨转移患者血清N-MID、CK5/6表达水平均发生异常变化,二者可能是预测原发性肺癌患者发生骨转移的敏感指标。Objective To explore the expressions of serum N-terminal osteocalcin(N-MID)and cytokeratin(CK)5/6 in primary lung cancer patients with bone metastasis and their clinical significances.Methods The clinical data of 96 patients with primary lung cancer admitted to Chengdu Second People's Hospital between February 2019 to February 2022 were retrospectively analyzed.All patients were divided into the bone metastasis group(38 cases)and the non-bone metastasis group(58 cases)according to whether bone metastasis occurred,and 45 healthy people who underwent physical examination during the same period were treated as the healthy control group.The expression levels of serum N-MID and CK5/6 in the bone metastasis group,the non-bone metastasis group and the healthy control group were compared.Logistic regression was used to analyze the factors affecting bone metastasis in patients with primary lung cancer;receiver operating characteristic(ROC)curve analysis was used to analyze the value of the expression levels of serum N-MID and CK5/6 in predicting bone metastasis in patients with primary lung cancer.Results The composition ratio of patients with pathological stageⅢ-Ⅳ,serum bone-derived alkaline phosphatase and N-MID expression levels in the bone metastasis group were higher than those in the non-bone metastasis group(all P<0.05).The expression level of serum N-MID in the bone metastasis group and non-bone metastasis group was higher than that in the healthy control group[(26.0±5.3)ng/ml,(15.3±3.1)ng/ml vs.(9.9±1.7)ng/ml,F=224.27,P<0.001],and there were statistically significant differences in the serum N-MID expression level of the pairwise comparison among the three groups(all P<0.05).The expression level of serum CK5/6 in the bone metastasis group and the non-bone metastasis group was lower than that in the healthy control group[(3.6±0.7)ng/ml,(7.3±1.4)ng/ml vs.(10.6±2.4)ng/ml,F=178.11,P<0.001],and there were statistically significant differences in the serum CK5/6 expression level of the pairwise comparison amo

关 键 词：肺肿瘤 肿瘤转移 骨 N-端骨钙素 细胞角蛋白5/6 

分 类 号：R734.2[医药卫生—肿瘤]