血清MIC-1、LMTK-3和IGFBP-7水平检测在消融联合化疗治疗晚期肺癌患者预后中的评估价值  

Assess value of serum MIC-1,LMTK-3 and IGFBP-7 levels detection in the prognosis of patients with advanced lung cancer treated by ablation combined with chemotherapy

作　　者：戴斌 曾颖鸥 乔弟 邬云龙 王勐 王强 DAI Bin;ZENG Ying′ou;QIAO Di;WU Yunlong;WANG Meng;WANG Qiang(Department of Thoracic Surgery,Zhoupu Hospital Affiliated to Shanghai Medical College,Shanghai 201318,China)

机构地区：[1]上海健康医学院附属周浦医院胸外科,上海201318

出　　处：《检验医学与临床》2023年第16期2369-2374,共6页Laboratory Medicine and Clinic

摘　　要：目的观察血清巨噬细胞抑制因子1(MIC-1)、Lemur酪氨酸激酶3(LMTK-3)和胰岛素样生长因子结合蛋白7(IGFBP-7)水平在消融联合化疗治疗晚期肺癌患者预后评估中价值。方法选择2019年1月至2021年6月在该院就诊的晚期肺癌患者95例为肺癌组。选择同期在该院就诊的健康体检者45例为健康对照组。所有晚期肺癌患者采用经皮微波热消融疗法治疗,完成后1周内进行化疗。比较肺癌组和健康对照组、肺癌组治疗前后和不同疗效患者治疗前血清MIC-1、LMTK-3和IGFBP-7水平,对影响患者预后的因素进行单因素和多因素分析,分析血清MIC-1、LMTK-3和IGFBP-7水平预测晚期肺癌患者预后的效能。结果肺癌组治疗前后血清MIC-1和LMTK-3水平明显高于健康对照组,差异有统计学意义(P<0.05);肺癌组治疗前后血清MIC-1和LMTK-3水平较治疗前明显降低,差异有统计学意义(P<0.05)。肺癌组治疗前后血清IGFBP-7水平明显低于健康对照组,差异有统计学意义(P<0.05);治疗后肺癌组血清IGFBP-7水平较治疗前明显升高,差异有统计学意义(P<0.05)。治疗后肺癌患者出现完全缓解(CR)+部分缓解(PR)66例,稳定(SD)+进展(PD)29例,SD+PD晚期肺癌患者治疗前血清MIC-1和LMTK-3水平明显高于CR+PR晚期肺癌患者,而SD+PD晚期肺癌患者治疗前血清IGFBP-7水平明显低于CR+PR晚期肺癌患者,差异有统计学意义(P<0.05)。治疗前血清MIC-1和LMTK-3水平升高,IGFBP-7水平降低是晚期肺癌患者治疗后1年内发生死亡的独立危险因素(P<0.05)。血清MIC-1、LMTK-3和IGFBP-7水平联合检测预测晚期肺癌治疗后1年内发生死亡的灵敏度为91.3%,特异度为95.8%,AUC为0.974,其AUC明显大于MIC-1(Z=2.378,P=0.017)、LMTK-3(Z=2.897,P=0.004)和IGFBP-7(Z=3.213,P=0.001)单独检测的AUC,而3项指标单独检测的AUC比较,差异无统计学意义(P>0.05)。结论血清MIC-1、LMTK-3和IGFBP-7是消融联合化疗治疗晚期肺癌后的重要疗效评估指标,�Objective To investigate the clinical value of serum levels of macrophage inhibitory factor 1(MIC-1),Lemur tyrosine kinase 3(LMTK-3)and insulin-like growth factor binding protein 7(IGFBP-7)in the prognosis of patients with advanced lung cancer treated by ablation combined with chemotherapy.Methods A total of 95 patients with advanced lung cancer treated in the hospital from January 2019 to June 2021 were selected as the lung cancer group.A total of 45 healthy subjects were selected as the healthy control group.All patients with advanced lung cancer received chemotherapy within 1 week after percutaneous microwave thermal ablation.The serum levels of MIC-1,LMTK-3 and IGFBP-7 between lung cancer group and healthy control group,before and after lung cancer treatment and patients with different therapeutic effects were observed.Univariate and multivariate analysis were performed on the factors affecting the prognosis of patients,and the efficacy of serum MIC-1,LMTK-3 and IGFBP-7 in predicting the prognosis of patients with advanced lung cancer was analyzed.Results Before and after treatment,serum MIC-1 and LMTK-3 levels in lung cancer group were significantly higher than those in healthy control group,the differences were statistically significant(P<0.05).The levels of serum MIC-1 and LMTK-3 in lung cancer group after treatment were significantly lower than those before treatment,the differences were statistically significant(P<0.05).The serum IGFBP-7 level in lung cancer group before and after treatment was significantly lower than that in healthy control group,the difference was statistically significant(P<0.05).After treatment,the serum IGFBP-7 level of lung cancer group was significantly higher than that before treatment,the difference was statistically significant(P<0.05).After treatment,there were 66 cases of complete response(CR)and partial response(PR),29 cases of stable(SD)and progressive(PD).Serum MIC-1 and LMTK-3 levels in SD and PD patients with advanced lung cancer were significantly higher than those in

关 键 词：巨噬细胞抑制因子1 Lemur酪氨酸激酶3 胰岛素样生长因子结合蛋白7 消融 晚期肺癌 

分 类 号：R446.1[医药卫生—诊断学]